Rural Affairs, Land Reform and Islands
Good afternoon. The first item of business is portfolio questions on rural affairs, land reform and islands.
I invite members who wish to ask a supplementary question to press their request-to-speak buttons during the relevant question. Members will be aware of the new time limits; as they will be rigorously applied, brevity in questions and responses will be welcome.
Rural Economy Measures (Midlothian South, Tweeddale and Lauderdale)
This is a test case.
To ask the Scottish Government how the measures in its programme for government 2023-24 will support the rural economy in the Midlothian South, Tweeddale and Lauderdale constituency. (S6O-02488)
All the Scotland-wide commitments in our ambitious PFG contribute to our rural economy, but there is a range of commitments within it that relates specifically to rural industries, supporting jobs and businesses in constituencies such as Christine Grahame’s. Those commitments include paying Scottish farmers and crofters £550 million of payments, beginning this month, and investing £1 million in skills development for woodland creation and in nature and peatland restoration.
Businesses and communities in the Midlothian, Tweeddale and Lauderdale area will also benefit from our PFG commitment to support the ambitions of the Edinburgh and south-east Scotland city region in developing and implementing its regional economic prosperity framework.
Yesterday’s debate highlighted the contribution of our farming sector to our economy. Given that many farmers are not as young as they used to be, what support is being given to encourage young people into the sector?
First of all, I am delighted to update Parliament that, as promised in this year’s programme for government, we have now started making our payments to farmers and crofters, two weeks ahead of schedule. Initial payments worth approximately £288 million are now being paid to more than 13,000 businesses all across Scotland, including in Christine Grahame’s constituency. Unlike in England, we are ensuring stability by maintaining direct payments. In the coming year, we will pay Scottish farmers and crofters £550 million to support actions to produce food.
Christine Grahame also—rightly and importantly—mentioned new entrants to the industry. Another commitment in our programme for government commits us to working with them to develop new support for new entrants.
Crofting Law Reform
I refer members to my entry in the register of members’ interests in relation to both crofting and the fact that I am a member of the Faculty of Advocates.
To ask the Scottish Government for what reason its programme for government 2023-24 did not include a commitment to a crofting bill. (S6O-02489)
The programme for government 2023-24 commits the Scottish Government to developing and consulting on proposals for reform of crofting law. That is a key and necessary part of the process of developing and then introducing a bill, which we remain committed to doing in this parliamentary term.
The cabinet secretary might be aware that crofting reform of some sort has been pledged by this Government in 2014, 2015, 2016, 2017, 2018, 2022 and now in 2023. However, in that time, there has been little movement, despite calls for reform from crofting communities. What assurances can the cabinet secretary give those communities that the most recent pledge will not end up in the long grass, like the many pledges that have gone before it?
I disagree with the member. We committed to introducing a crofting bill this parliamentary term, and that is exactly what we have set out to do.
In order to do that and to consider the proposals that were brought forward previously, we reintroduced and re-established the crofting bill group. It has met 11 times so far, with further meetings planned so that we can develop those proposals further.
As I set out in my initial response, there is a process that we go through in developing legislation. That is why we have committed to introducing a consultation on the measures that we will be bringing forward for a bill.
I look forward to seeing the bill that the cabinet secretary has confirmed. Does she agree, however, that it is quite difficult for Opposition parties to cast themselves as champions for crofting while they are content, by their silence, to allow their colleagues at Westminster to leave crofters totally in the dark over the future of less favoured area support scheme funding?
Yes, I agree. The imposed Brexit that we have had forced on us in Scotland means that rural Scotland, in particular, has been badly let down. LFASS, or funding to support those who need it most—that is, those who farm and croft in Scotland’s most marginal areas—might not matter to the UK Government; after all, in the last common agricultural policy, it chose not to provide that funding in England. However, as more than 80 per cent of all land in Scotland is in less favoured areas, it really does matter to us, and in particular to our crofters.
Multiyear certainty has been replaced with absolutely no commitment for funding beyond 2025. That is a result of the choices that were made by the United Kingdom Government and its refusal to deliver on its own public commitment to engage meaningfully on future budgets.
The cabinet secretary will be aware that a crofting bill was promised in the previous session of Parliament. The problems with crofting were caused by the bill that became the Crofting Reform (Scotland) Act 2010, and we desperately need a bill to put right what was done wrong in that legislation. Will the cabinet secretary either repeal the previous legislation or bring forward a new bill immediately? The current legislation is a dead hand on crofting.
All of the issues that the member has highlighted, and which have been raised previously, are being considered by the crofting bill group. Again, it is our intention to provide that clarity in law, to tidy up the current legislation and to better regulate crofting.
As I said in my previous responses, the crofting bill group was formally re-established in May last year, and right now it is considering at least 50 different issues to determine which will feature in the bill that we bring forward. Of course, there will be wider engagement and consultation on that in due course, and I look forward to engaging with members on all sides of the chamber as we develop the legislation.
Proposed Land Reform Bill
To ask the Scottish Government whether it will provide an update on the progress of its proposed land reform bill. (S6O-02490)
As set out in the programme for government, we are committed to introducing a land reform bill to further improve transparency of land ownership; to help ensure that large-scale land holdings deliver in the public interest; and to empower communities by providing more opportunities for them to own land and to have more say in how land in their area is used. The bill will also include measures to modernise agricultural holdings.
My constituents on the island of Great Bernera have for a number of years been fighting to buy their land from an unco-operative and entirely absent landowner, who often leaves correspondence unanswered for months on end or ignores it altogether. Can the cabinet secretary outline whether there will be any provisions in the upcoming bill to prevent absentee landowners from delaying matters in that way?
I am aware of the issues that Alasdair Allan has raised in his question, and I am also aware that he has supported his constituents for a number of years and, indeed, led a members’ business debate on the issue and on the situation with the community group. I absolutely understand and appreciate the frustration that I know both he and the people on Great Bernera must feel at the situation in which they find themselves.
I know that in Scotland we have landowners who are focused on making a positive impact in their local communities and who work with those communities to do so. However, that is not universal, and I accept that there is more that the Government can do in this area. That is why our land reform bill proposals will seek to strengthen the obligations on landowners to comply with the “Scottish Land Rights and Responsibilities Statement 2022” as well as looking to introduce compulsory land management plans.
Trump International golf links in Aberdeenshire has long faced opposition from local residents who are concerned about the social and environmental impact of the development. Under the Government’s current land reform proposals, a 560-hectare holding such as Trump International would not be considered “large” and so would not be subject to a public interest test. Does the cabinet secretary agree that land of that size should be accountable to local communities and the wider public?
I know that Mercedes Villalba is looking to bring forward proposals in that area and that the consultation on her draft member’s bill has just closed. I look forward to considering the detail of her proposals.
We are not proposing to put a cap on land ownership, because we are not persuaded that a cap is supported by adequate evidence. In addition, such a cap is unlikely to be compatible with the European convention on human rights. It is vital that we take cognisance of such considerations.
That is why our proposals seek to empower communities by providing them with more opportunities to own land through enabling them to receive prior notification of impending sales or transfers, as well as giving them more say on how land in their area is used. Our proposals will, of course, be fully compliant with ECHR and the terms of the devolved settlement.
Question 4 was withdrawn.
Farm-to-fork Food Production
To ask the Scottish Government what its position is on the greater use of farm-to-fork methods to encourage domestic food production. (S6O-02492)
The Scottish Government is, of course, hugely supportive of greater use of farm-to-fork methods to encourage domestic food production and consumption. As an example, £490,000-worth of funding is being provided through the food for life programme over the course of this financial year so that more locally sourced, healthier food is provided in schools. We are also funding a Glasgow-based pilot on expanding the principles of the food for life programme into the wider public sector.
It was important that we were able to talk about some of those issues in yesterday’s food and drink debate, and it is fantastic to be able to discuss food and drink in Scotland and to celebrate our superb natural larder during the current food and drink fortnight.
I agree that the issue is an important one. Given that the European Commission has softened its approach to gene-editing technology over the summer, will the cabinet secretary not recognise, as the Scottish Conservatives do, that the use of gene-editing technology would provide the best security for domestic food production in Scotland?
I know from yesterday’s food and drink debate that the Tories seem to think that gene editing will solve all the problems in relation to food production and food security. However, the Scottish Government is not in a rush to legislate on such matters in the way that the United Kingdom Government was, simply to prove a point about being different from the European Union. We must fully consider all the relevant factors. That means having a discussion about gene editing with our farmers, scientists and, importantly, our consumers before we decide how to move forward. Of course, we will look at developments in the EU as they progress, too.
Unlike the UK Government, we would like to take the time to consider the gene-editing proposals fully and to understand what the implications of the use of such technology would be for Scotland.
Given that the free trade agreements threaten to harm domestic production and flood our market with imported goods of lesser quality, I find it ironic that Meghan Gallacher has asked such a question. Given the Scottish Government’s commitment to active farming and food production, does the cabinet secretary agree that the best thing that the Tories could do to help to ensure the future of domestic food production is lobby their colleagues in the UK Government to provide funding clarity for the agriculture sector post-2025?
Absolutely, because right now we have absolutely no clarity on long-term funding and what that will look like beyond 2025. So far, the Treasury has provided only yearly allocations—no commitment has been made beyond those. Whoever is in power at Westminster, we need to know how much funding we will have to support farming and other rural priorities. I absolutely share the frustration that our farmers and food producers have expressed about the lack of future budget clarity.
We also need to have a fair funding settlement that will not be cut arbitrarily from year to year by Westminster, so that we can create a multi-annual framework. We would, of course, get all of that if Scotland was independent and back in the EU.
Grain Harvest
To ask the Scottish Government what preparations it has made in response to the protracted start to the 2023 grain harvest. (S6O-02493)
The Scottish Government supports farmers in preparing for and responding and adapting to challenging conditions over the course of the season by ensuring that timely and effective advice and support are available to inform decision making.
That support includes Scotland’s Rural College’s crop protection report, which offers online, free-of-charge regular analysis by region of current issues for a range of crops. That includes the provision of fortnightly local reports on the progress of the grain harvest over the season, which aids farmers in making informed decisions for their crops. The Government’s support also includes the Farm Advisory Service, which facilitates largely free access to high-quality generic and bespoke advice for the agriculture sector.
The cabinet secretary will know that that information shows that it has not been an easy start to the 2023 grain harvest, not just because of the delays but because of poor quality in some crops. That is particularly true of barley in my area, which is causing concern not to farmers but to the Scottish whisky industry.
In the light of the fact that we do not have any clarity about the agriculture bill, can the cabinet secretary reassure grain farmers that they will be supported?
I would not agree with the member’s statement that there is no clarity on the agriculture bill. We have previously made a commitment, which I maintain, to introduce this year an agriculture bill in which we will continue to support our farmers and crofters as we have done in the past. We will continue to support our food producers with direct payments, which is another commitment that we previously made and which I stand by.
Over decades, precision crop breeding has led to modern varieties of cereal crops delivering higher yields and more resistance to a wide range of environmental stresses. However, the development of those new varieties takes time. With clear signs that the European Union will change its position on gene editing, when will the Scottish Government commit to a policy that will allow our world-leading institutions such as the James Hutton Institute to adopt GE as a crop-breeding tool, which would bring huge benefits to our farming communities? Can the cabinet secretary set out the timescale for that discussion to take place?
Again, we fully support innovation when it comes to our agriculture sector. As Finlay Carson is aware, we have world-leading institutes—he named one of them—doing world-leading work and science in that area.
I have outlined in a previous response where we stand on gene editing at the moment. Of course, we are carefully considering what happens elsewhere in the EU, but we also have to understand and fully consider the wider ramifications before taking any steps forward where that could affect future trade. Again, we will make sure that we engage everyone in the conversation when we do that.
Scottish Land Commission (Compulsory Sales Orders and Land Value Capture)
To ask the Scottish Government whether it will provide an update on its consideration of the Scottish Land Commission’s work on compulsory sales orders and land value capture. (S6O-02494)
The programme for government, which was published last week, reiterates our commitment to consider the justification for, and practical operation of, compulsory sales orders and implement new infrastructure levy regulations by spring 2026. The levy would provide local authorities with an additional mechanism for securing developer contributions, alongside planning obligations.
I welcome the commitment in the programme for government and that progress. The cabinet secretary will be aware of the housing crisis that we have here, in Edinburgh, which is partly due to the extremely high cost of land. I would therefore encourage the cabinet secretary to continue to work with her Government colleagues, including the housing minister, on the low-carbon vacant and derelict land investment programme and to continue to engage the City of Edinburgh Council and parliamentarians in Edinburgh to work together to unlock and reduce the price of unused land in the capital.
The member raises some really important points in his question.
I would like to outline that, since 2020-21, the City of Edinburgh Council has received three awards from the low-carbon vacant and derelict land investment programme, totalling just under £3.5 million, to support affordable housing in the public realm in Granton and Greendykes. The low-carbon vacant and derelict land investment programme tries to support ambitious local proposals to tackle persistently vacant and derelict land, place-based regeneration and our 20-minute neighbourhood aspirations as part of our just transition to net zero.
My Government colleagues and I will be happy to engage with the member and others who represent the city region, as well as the council, to see how we can take forward those issues and take action on them.
Land value capture and compulsory sales orders are obviously complex issues, and any policy in this area will have to be both detailed and flexible to recognise the vast range of circumstances in which such powers might be considered. If the Scottish Government is going to take the measures forward, can the minister assure us that compulsory sales will be a last resort and that a sale will be permitted only to buyers who have a fully developed and funded plan for land use?
We are obviously not yet at the stage of taking such decisions. As the member rightly touches on, this is a complex area, which is why we need to take forward the work on it and why we set it out in our programme for government. I am aware that I have an upcoming meeting with the member, at which I would be happy to discuss the issues and how we intend to take them forward.
Seventeen per cent of Scotland’s population is made up of people living in rural areas, yet, last week, the First Minister announced that he will be allocating just 10 per cent of new funding for building affordable homes to rural areas. Does the cabinet secretary accept that that is an outrageous disparity, and will she push back on his plan to underfund rural housing?
This Government is committed to building more houses than any previous Scottish Government or any Government anywhere else across these isles. I recognise that the member raises an important point on the availability of housing. When I travel to rural parts of Scotland, including our islands, housing is a key issue, and the need for more housing is mentioned. That is why the Minister for Housing has been working on developing a remote, rural and islands housing action plan to look at how we can tackle those issues by working with the third sector, other enterprises and business. Good work is happening across the country at the moment, but the issue is how we focus that and drive house building forward.
Interisland Connectivity (Tunnels)
To ask the Scottish Government what cross-government consideration there has been regarding the use of tunnels to improve connectivity between the islands. (S6O-02495)
Transport Scotland regularly engages with colleagues across the Scottish Government in the islands, planning, housing, population and infrastructure teams in the context of improving transport connectivity to and from Scotland’s many islands.
I recently visited Shetland, Orkney and Mull, during which time I had several discussions on the matter of tunnels and fixed links replacing existing ferry services. Although transport is a devolved matter, this week I had a discussion on the replacement of the Fair Isle ferry with United Kingdom Government minister Richard Holden. That discussion did not extend to fixed links to our islands.
In July, Shetland Islands Council wrote to the Secretary of State for Scotland and the First Minister, asking to meet about tunnels and other matters. A date has been arranged for the council leader to meet Alister Jack in London. Has the First Minister responded? If not, why not?
I was very pleased to meet Shetland Islands Council in August to discuss these matters. As far as the First Minister and I are aware, in September, Shetland Islands Council committed to spending £700,000 considering the business case for four potential new fixed links in the Shetland Islands. It has direct responsibility for the matter.
On the invitation to the First Minister, I understand that it was for later in September, but I may be wrong about that. I am not responsible for his diary, but I understand that an invitation is being actively considered. I am sure that there will be a response, as the member might expect, in due course.
With the growing space, salmon and renewable energy sectors in Shetland and the reported growing interest of the UK Government in meeting Shetland Islands Council about short subsea tunnels, will the Scottish Government commit to a date to meet Shetland Islands Council specifically to discuss tunnels?
I thank the member for hosting my meeting with the Unst and Yell tunnel action groups when I visited. I also met Shetland Islands Council and ZetTrans on the issue of fixed links, precisely for the reasons that were set out. The growing economic links were part of that agenda item back in August, and those discussions will continue.
I have indicated to the members whom I met in Shetland that Transport Scotland stands ready to assist with any of the business cases that they are currently putting together.
NHS Recovery, Health and Social Care
The next portfolio is national health service recovery, health and social care. I advise members that questions 6 and 8 have been grouped together. Supplementaries on those questions will be taken after both questions have been asked and answered. As ever, I invite members who wish to ask a supplementary question to press their request-to-speak button during the relevant question.
Neurodivergent Children (Pathways to Diagnosis)
To ask the Scottish Government, in light of the First Minister's commitment in the programme for government 2023-24 to publish a new delivery plan for mental health and wellbeing, what it is doing to improve pathways to diagnosis for neurodivergent children. (S6O-02496)
Following publication of the mental health and wellbeing strategy in June 2023, we will publish a delivery plan later this autumn that will set out the steps that we will take to improve support for children with neurodevelopmental support needs.
As set out in the strategy, we are committed to working in partnership to strengthen support and care pathways for people who require neurodevelopmental support. To do that, we will build on work to implement the neurodevelopmental specification for children and young people, including five tests of change across Scotland, working closely with partners to share learning and improve services and support.
I have had personal experience and received constituent feedback often highlighting gatekeeping at what should be access points to a diagnostic pathway. How is the Scottish Government ensuring unimpeded access to and support for neurodivergent individuals at key points, such as education and community health, so that they can uphold their dignity and prevent additional mental health issues?
It is important for me to say in response that a diagnosis is not required for children and young people to receive support. The neurodevelopmental specification makes it clear that support should be in place to meet the child or young person’s requirements at the earliest opportunity rather than being dependent on a formal diagnosis. For many children and young people, such support is likely to be community-based and it should be quickly and easily accessible.
We will continue to work with key partners from local authorities, education and health to implement the neurodevelopmental specification right across Scotland.
The Lowit unit in the Royal Aberdeen children’s hospital provided day care and out-patient support to children and young people with autism spectrum disorders, but it closed almost a decade ago. Families in the north-east are crying out for dedicated post-diagnostic support such as that given by the Lowit unit. What action is Scottish Government taking with health boards and local authorities to ensure that such support is in place?
The member will be aware that, when we approach this issue, we aim to help children and families to access support and services that meet their needs using the getting it right for every child—GIRFEC—approach. For many children and young people, such support is likely to be community-based and it should be quickly and easily accessible. There are a number of different models around the country, and, as I said, we are exploring five tests of change around the country. At the end of October—I think—we will come together to share the learning from those tests of change and to make sure that we can implement and roll them out all over the country.
Alcohol-specific Deaths
To ask the Scottish Government what its response is to the number of alcohol-specific deaths in 2022. (S6O-02497)
In Parliament on 7 September, I outlined the Government’s plan to reduce alcohol harms and deaths in response to the alcohol-specific deaths in 2022 and committed to a debate on the plan in more detail. It includes evaluating minimum unit pricing and alcohol marketing consultation responses. We will publish the recommendations of Public Health Scotland’s review on alcohol brief interventions and we have asked PHS to investigate reductions in the number of referrals to services.
Approximately £113 million is available to support initiatives responding to local needs, underpinned by the forthcoming treatment standards and workforce action plan to improve quality and capacity.
In April, it was revealed to me in a written answer to a question from the minister that the Scottish Government had cut alcohol and drug recovery services by £19 million in 2022-23. Now that we have seen a 14-year high in the number of alcohol-related deaths, and Scotland remains the drug death capital of Europe, does the minister accept that those cuts have had a devastating effect on people’s suffering with drug and alcohol misuse, and will she commit to restoring funding to those services in 2023-24?
It is important to point out that, in my response to the member’s question, I outlined that there has been no reduction in the funding that has been made available to alcohol and drug partnerships. Indeed, the funding that has been made available to them has increased year on year. Last year, £106.8 million was available to alcohol and drug partnerships, and this year £113 million was made available to them. We asked them to use their reserves appropriately and then draw on the funding. However, that funding is then moved forward and used in other ways in the alcohol and drug partnerships themselves, so there has been no overall reduction in funding.
I will bring back to the chamber a debate to discuss a cohesive plan, because I recognise that members across the chamber are looking to understand what the Government is doing to tackle alcohol-specific deaths and alcohol harm.
The Scottish Government’s world-leading minimum unit pricing policy has been shown to have a welcome impact on tackling alcohol-related harm. Can the minister provide any update on work to review the price level?
Work on renewing the level of the minimum unit pricing is under way, as the impact of MUP is connected to the unit price. It is important that we have a robust evidence base to support any decision on the change of the level of the MUP. As outlined in the programme for government, we will publish our final report on the operation and the effect of MUP later this month in Parliament, alongside a consultation on the MUP’s future around both its price and the continuation of the scheme.
Question 3 was not lodged.
NHS Fife (Meetings)
To ask the Scottish Government when it last met with NHS Fife and what was discussed. (S6O-02499)
Ministers and Scottish Government officials regularly meet representatives of all health boards, including NHS Fife, to discuss matters of importance to local people.
A current NHS Fife issue concerns the new medical centre for Lochgelly. Further to his most welcome visit last week, does the cabinet secretary recognise that Lochgelly has waited an awful long time and that its new medical centre deserves to be treated as a priority?
I am grateful to Annabelle Ewing for her question and for her invitation to visit the health centre in Lochgelly last week. I put on record my thanks to those people in the local community and the staff in the health centre for their time and the engagement that I had with them during my visit.
In my view, the health centre needs to be replaced. However, as I outlined to Annabelle Ewing and the local community, the health centre was not in the infrastructure investment plan for 2021 to 2026; alongside that, we have to undertake a review of our capital expenditure due to a cut in our capital budget by the United Kingdom Government; and construction inflation has had an impact , too, because it has significantly pushed up the cost of existing projects.
I assure the member that we will continue to look at what can be done, because I recognise the need for the health centre in Lochgelly to be replaced.
I was alarmed that NHS Fife reported a £7.9 million revenue overspend over the summer, only two months into the fiscal year. I would be concerned if attempts to bring that overspend back under control resulted in the loss of staffing, especially when the waiting lists are enormous. What steps is the Government taking to protect services in Fife?
One of the actions that we are taking to protect and improve services in Fife is the construction of our new national treatment centre there, which is delivering additional capacity to the kingdom of Fife and for patients in that area. That is a significant investment that will improve services.
I assure the member that we will provide boards that are projecting overspends with tailored support and that we will engage with them to try to manage the financial pressures that they face. I hope that the member recognises that the creation of the NTC in Fife is a clear demonstration of the Government’s commitment to improving services there.
General Practitioner Practices (Maintenance Backlog)
To ask the Scottish Government what steps it is taking to urgently address the reported maintenance backlog in general practitioner practices. (S6O-02500)
Over the next four years, we will invest £73 billion in health and care services and a further £1.3 billion in capital funding, doubling our investment in maintenance and equipment replacement to support their recovery, sustainability and reform. That investment is in addition to the annual primary medical services allocation, which includes £68 million for the provision and maintenance of the general practice estate. The Scottish Government will continue to work with boards to address financial pressures across the system.
The cabinet secretary will know that the current maintenance backlog in GP surgeries stands at £78.5 million, which is already over the budget that he has set out. He knows that there is a shortage of GPs, that primary care budgets have been cut and that a recent British Medical Association survey found that only 5 per cent of doctors thought that their practice was sustainable. With services already stretched, what more can the cabinet secretary do to set aside capital funding during the next three years in order to repair GP practices?
I am not entirely sure that the figure that Jackie Baillie quoted is correct. Within the data that she is using, I suspect that there is a range of additional lifetime recurring costs, which is normal for capital projects.
As I have already outlined, we are in a situation in which the Scottish Government’s capital budget has been cut by the United Kingdom Government, which has a direct impact on how much we can invest in our capital estate. Alongside that, we are also having to deal with a significant increase in capital project costs as a result of construction inflation. We will continue to do everything we can to invest in capital projects, but there are significant challenges. A capital review is being taken forward by the Deputy First Minister in order to look at what further action we will have to take in order to address the financial pressures that we are facing in our capital budgets.
Community Link Workers (NHS Greater Glasgow and Clyde)
I remind members of my entry in the register of members’ interests. I am a practising national health service general practitioner.
To ask the Scottish Government what its response is to reported plans by NHS Greater Glasgow and Clyde to reduce the number of community link workers embedded in GP practices in deprived areas of Glasgow by one third, due to Scottish Government funding cuts. (S6O-02501)
I am very concerned about the risk to link workers in Glasgow from April 2024, as they provide a vital service in disadvantaged areas. My officials are engaging with the health and social care partnership on its plans for primary care in 2024-25, and are exploring all options to avoid a reduction in posts.
I have received several letters from deep-end practices in Glasgow telling me how invaluable community link workers are. I also met with one of those practices. Those cuts are a direct threat to the stability of the practices, and the loss of community link workers will have a severe impact on the most vulnerable patients in our communities.
The Scottish National Party made a manifesto commitment to increase community link workers in GP surgeries and promised to invest in practices in disadvantaged areas. Why are we seeing the opposite? Will the Scottish Government ensure that those cuts are reversed?
Unfortunately, Mr Gulhane is incorrect. This is not a result of Scottish Government budget cuts. The funding for community link workers comes from the primary care improvement fund, which still stands at £190 million. Glasgow’s health and social care partnership has gone beyond the funding that was provided to it for the delivery of community link workers, which it is no longer able to sustain. The member may be aware that this year we stepped in and provided an extra £1.3 million in order to protect posts in this financial year. We are continuing to engage with the health and social care partnership in order to make sure that it has a sustainable position and that it supports those invaluable workers who are working in some of the most challenging GP practices in the country.
Community Link Workers
To ask the Scottish Government whether it will provide an update on the 2021 Scottish National Party manifesto commitment to expand on the community link worker programme. (S6O-02503)
Due to difficult decisions during the emergency budget review, recruitment to additional roles to support community mental health resilience and ensure that every general practice has access to a dedicated mental health and wellbeing service has not yet commenced. However, we have already prioritised significant investment to build primary care mental health capacity through action 15 and the primary care improvement fund. More than 540 whole-time equivalent primary care mental health workers have been recruited through those funds. We remain committed to improving mental health service provision in primary care settings.
As Dr Gulhane mentioned, the proposed reduction in community link worker posts in Glasgow will be felt most acutely by the deprived communities in the city. Last week’s programme for government committed to ensuring that services such as the community link worker programme can respond to local needs in the year ahead. However, link workers and GP practices are facing uncertainty in the here and now. It is not good enough for the cabinet secretary to simply pass the buck. Will he commit to getting around the table with the Glasgow city health and social care partnership and the GMB trade union in order to ensure that link worker provision is maintained at its current level and that it can be funded more sustainably in the longer term?
As I mentioned in response to Mr Gulhane’s question, we are already engaging with the health and social care partnership in Glasgow to understand its plans for the primary care improvement fund, and we will continue to engage with it in order to try to address the issues that it faces in relation to community link workers.
I recognise the important value of those workers, and we want to ensure that they are maintained in order to support GP practices in some of our most deprived communities.
This week I met with general practitioners in Easterhouse in my Glasgow Provan constituency. They expressed deep concern about proposed reductions to the hugely valuable community link worker programme and highlighted reductions in GP workload and in prescriptions issued as a consequence of the work that is undertaken by the link workers. They also highlighted a carbon cost to the proposed reductions, as prescriptions are one of the health service’s biggest sources of carbon emissions.
The reductions are a false economy at a time when we should be moving towards preventative medicine. Has the Scottish Government done any assessment of the additional costs in terms of GP time, additional prescriptions and, indeed, our carbon footprint that would arise from the proposal?
We have not carried out such an assessment on general practices or the wider system. However, we recognise the important value that community link workers have as part of the multidisciplinary team in primary care settings, which is why we take seriously the issues that are being highlighted by members around the potential impact on community link workers in Glasgow and why we have already started the process of engagement with the health and social care partnership in Glasgow to understand how it plans to use the investment that we are providing it with around the primary care improvement fund.
However, I also underline the point that we have already stepped in to provide financial support to the health and social care partnership to allow it to continue those posts in this financial year. It is important that the partnership has a sustainable financial pathway to supporting those posts.
Community Midwifery Services
To ask the Scottish Government how it plans to invest in community midwifery services to ensure that they are consistently delivered in areas of need rather than in centralised, and often hard-to-access, locations. (S6O-02502)
We remain committed to ensuring that maternity services continue to be developed in a flexible and innovative way, recognising local population needs and geographic challenges. Over the past five years, the Scottish Government has invested more than £25 million to support implementation of the best start programme, which includes recommendations for continuity of carer and the delivery of community hubs. We also published the “Continuity of carer and local delivery of care: implementation framework”, which is designed to assist national health service board implementation. That will be based on a local assessment of the viability, scope and potential impact of hubs. Community midwives also deliver care in women’s homes, as necessary.
I have met midwives across the South Scotland region and what is clear to me is that there is now significant pressure on midwifery professionals’ ability to deliver regular high-quality community-based services to those most in need. It is the Government’s lack of a proper education and workforce strategy for midwives and its inability to support rural health boards with high numbers of vacancies that are contributing to those pressures. Will the Government accept that fact and set out in full the action that it can take that will ensure that midwives are supported to provide community-based services in areas that are most in need?
A couple of weeks ago, I met a number of midwives from across Scotland at their conference, and it was heartening to hear the progress that the best start programme has brought about within midwifery. We also work closely with the national midwifery task force.
I know that the member has written to me on other subjects and I am happy to meet her to discuss those issues and the issue that she has raised today.
Continuity of carer was a key recommendation of the Scottish Government’s best start plan to reshape maternity and neonatal services with a vision of relationship-based continuity of carer, tailored to the individual’s needs and delivered as close to home as possible. Can the minister provide any update on the Scottish Government’s work to progress that recommendation?
All boards continue to work towards implementation of continuity of carer following a pause during the Covid-19 period. We have reconvened the best start leads group and have held learning events and deep-dive sessions to support boards with the implementation of continuity of carer, the most recent being on 30 August. In addition, we have written to boards asking them to continue to prioritise the roll-out of continuity of carer, with a particular focus on socially complex women and families and on women with poorer maternity outcomes, and boards will report back to us on how they are progressing with that work.
That concludes portfolio questions.