Rural Affairs and Islands
Good afternoon. We start with portfolio questions, and the first portfolio is rural affairs and islands. There is a lot of interest in this and the next portfolio, so I make the usual plea for succinct questions and responses, and I advise that where I do not think that the question or the response is succinct, I will be intervening. I invite anyone who wishes to ask a supplementary to press their request-to-speak button during the relevant question.
Second Home Ownership (Rural and Island Communities)
To ask the Scottish Government, in relation to its cross-Government co-ordination on islands policies, what discussions the rural affairs secretary has had with ministerial colleagues regarding regulating second home ownership in rural and island communities. (S6O-02100)
The Cabinet Secretary for Rural Affairs, Land Reform and Islands regularly engages with colleagues on a variety of issues, and I look forward to working with her on the important issue of rural housing.
Second homes bring benefits to those who own them and the businesses that they support, but in some communities they can impact the availability of homes to meet local need and it is important that we take action to pursue a fair balance. That is why we recently published a joint consultation with the Convention of Scottish Local Authorities, seeking views on giving powers to local authorities to increase the rates of council tax on second and empty homes.
The consultation on raising council tax on second homes is welcome, but I fail to see how that policy will have any impact on the numbers of second homes, which we know can be an issue.
The Highlands is the area that is most affected by second homes. Ullapool is one of many towns that are affected, and Ullapool Community Trust recently described the lack of housing supply there as a “real and persistent crisis”. Second homes reduce available stock for local families and can push up prices well beyond the reach of key workers. Then, businesses and the public sector can struggle to attract staff, as there is no housing available for workers.
One solution may be for our councils in hot-spot areas to limit second home numbers. Will the Government commit to looking seriously at that option?
The Government is looking at a few things just now. We will publish an action plan for housing in remote, rural and island areas that will include up to £25 million from our affordable homes budget to allow suitable properties, including empty houses, to be purchased for long lease and turned into affordable homes for key workers and others. Ash Regan raised an important issue, and I have been engaging with ministers on that today. We recognise that good-quality affordable housing is essential to help attract people to remote and rural communities and to retain them.
The point that you make is something that I would pick up with you in further discussions, if that is okay. We need to think about how we try to attract first-time buyers into such areas, because there is an issue regarding rural housing and depopulation. That is an important point, which we are looking at. There is support for first-time buyers under land and buildings transaction tax, which increases the upper amount of the nil rate from £145,000 to £175,000 and saves first-time buyers up to £600 in tax.
It is a complex issue and there a number of things that we need to look at. The rural action plan that I talked about will be a major step forward, and there are a few points that she mentioned—
Minister, if you could address your comments through the microphone rather than to the member, I am sure that we will pick them up.
I welcome the COSLA and Scottish Government consultation, which aims to tackle the matter of the disproportionate number of second homes in many parts of Scotland, not least my own constituency. What additional measures will be put in place to introduce a limit on the proportion of second homes in comparison to homes that are lived in year round in specific communities, specifically because of the wider impact that the issue has on house prices in such places, which pushes all but a very small number of people out of the housing market?
The member will be aware that there are already additional measures that can support areas to manage the numbers of second homes and short-term lets, such as the introduction of short-term let control areas and the increase in the LBTT additional dwelling supplement to 6 per cent, which helps first-time buyers compete more fairly with buy-to-let investors or people buying second homes.
I mentioned the consultation and I look forward to seeing the responses about providing councils with powers that they can choose to use to achieve fairer taxation on housing. That will inform our next steps on this important issue.
I will press the minister a bit further. Yesterday, he indicated that he might be prepared to go beyond only the council tax. We have done it for short-term lets in relation to planning and licensing. Would he be prepared to consider using that for second homes as well?
Yes. Again, if Mr Rennie wants to forward me proposals, I would be happy to look at them and discuss them. The First Minister mentioned that yesterday. If Mr Rennie has any proposals to forward, I would be more than happy to discuss them at a later stage.
Briefly, Katy Clark.
A recent Scottish Parliament information centre report revealed that Arran has the highest rate of second home ownership in Scotland, accounting for 25 per cent of all privately owned homes on the island. Only 11 per cent of Arran’s housing stock is available for affordable rent, and, of course, rents on the island are more expensive than those on the mainland.
Will the minister advise on when the Scottish Government’s remote, rural and island action plan for housing will be published and on what is being considered that will particularly address areas where there is a very high density of second homes?
As briefly as possible, minister.
As, I think, I mentioned, the action plan will be published relatively soon. I will let Katy Clark know when it is available, at that time. We talked about some of the issues that there are. The buy-to-let control areas, which I think I mentioned before, are one part of that. I plan to visit Argyll and Bute and other rural communities to engage with them and talk about the issues that have been raised. It is more complex than that. I talked about the consultation on the second homes supplement. Again, I would be keen to find out Argyll and Bute’s understanding of and position on that.
Highly Protected Marine Areas (Potential Impacts on Coastal and Island Communities)
To ask the Scottish Government what assurances it can provide to fishers in Na h-Eileanan an Iar constituency who have reportedly expressed concerns about their livelihoods and the future of their communities in light of the potential economic and cultural impact highly protected marine areas may have on coastal and island communities once designated. (S6O-02101)
First, I take the opportunity to say that I am aware of the strength of feeling arising from the highly protected marine area consultation. We remain committed to continued meaningful engagement with fishers and coastal and island communities. Our consultation has just closed and we are analysing responses and carefully considering feedback.
I reiterate that no sites have been proposed yet. Site selection will be a participatory process, and the expertise of fishers, among others, will be crucial to ensuring that the proposals provide benefits for the sustainable fishing of our marine ecosystems.
Members will appreciate the need to tackle biodiversity loss, but, in many parts of the Highlands and Islands, human communities are at risk, too. The population of my constituency has nearly halved since the second world war and it is projected to drop by another 16 per cent by 2042. Given fishing’s strong economic and cultural ties across the west coast, does the minister understand why HPMA proposals have now inspired a Skipinnish song, and can she say how the proposals can be reconciled with the Scottish Government’s commitments around depopulation and other items in the national islands plan?
I thank Alasdair Allan for his question and for his concern about the matter. This concerns us all. If we do not take action in the marine space, there is a risk that the marine environment will not remain resilient enough to continue to provide the resources and benefits that we gain from it for the long term.
Protecting our marine environment not only ensures that we protect the natural asset upon which the fishing industry and other industries are built but helps to manage the potentially devastating impacts of climate change on the industry. Communities can absolutely benefit from highly protected marine areas; indeed, the Lamlash Bay no-take zone was a result of campaigning by the local community group. Based on studies co-ordinated by that group, it has been noted that, since protection, commercially important species have increased in size, age and density.
I have requests for a number of supplementaries. They will have to be brief, as will the responses.
With communities up in arms and Scottish National Party back-bench rebellion looming, the Scottish Government now seems to be desperate to be seen to be listening on these plans. However, it has already caused huge anger among coastal communities. Will the minister now drop the plans, go back to the drawing board and engage fully to find agreement with local communities and stakeholders on a way forward?
Again, I absolutely appreciate the strength of feeling here. The consultation on these matters closed only on Monday. We will take the time to consider all the responses. Consultations are a tool that we use to collect views from interested groups. The Scottish Government is aware of the concerns of marine users and industries, including fishers, about the potential impacts that HPMAs may have on them. Those impacts may benefit certain fish stocks. HPMA studies show that they increase the stock, which can spill over into adjacent areas. That benefits fishers in the form of extra juvenile and adult animals, which has commercial benefit. Of course, HPMAs can also benefit recreational sectors.
Given the strength of feeling around HPMAs, will the minister listen to the consultation and withdraw the proposals, or does she see them as a red line in the Bute house agreement?
As I said in my previous answer, the consultation has only just closed. It includes a very wide range of views, which we will now consider and assess. Of course, it is important to create the right balance in our marine space. We recognise the importance of continued investment in Scotland’s seafood and wider marine sectors, as well as the importance of balancing the needs of ecomarine protection and renewable energy.
Briefly, Beatrice Wishart.
The minister talks about meaningful engagement and recognises the concerns that are being expressed across island and coastal communities throughout Scotland, but when will she meet the people who are most affected in their communities?
As briefly as possible, minister.
I reiterate that no sites have been selected for this. We want the site selection process to be participatory at every step of the way. This is part of a just transition for our marine spaces and our work towards net zero. We absolutely intend to have meaningful community engagement every step of the way.
Conditionality Payments
Before I start my question, I refer members to my entry in the register of members’ interests. I have been involved in a farming partnership for more than 40 years.
To ask the Scottish Government whether all farmers will have the ability to apply for, and be granted, all conditionality payments under its new agricultural support scheme. (S6O-02102)
Our vision for agriculture sets our clear commitment to maintain direct support for our producers. The Cabinet Secretary for Rural Affairs, Land Reform and Islands has said plainly in the chamber—and I re-emphasise—that our producers will not face any cliff edge as we transition to the four-tier support framework.
We will deliver with our industry to ensure that future support is most effective and accessible for all types of farmer, crofter and land manager, enabling them to continue to produce high-quality food and deliver on our shared outcomes for biodiversity recovery and climate adaptation and mitigation.
Unfortunately, that did not answer the question; let us try one more time. Fifty per cent of the future farm payment will be based on conditionality. Will all farmers across Scotland be able to apply for and be granted those grants, if appropriate—yes or no?
I appreciate the member’s concern. Our commitment to co-develop and work with those who are directly impacted and will be expected to deliver the outcomes on the ground has been important. That is reflected in our creation of the agriculture reform implementation oversight board—the ARIOB—which is co-chaired by the cabinet secretary and the NFU Scotland president Martin Kennedy. The member can be assured that the interests of all farmers are very well represented in that work.
What the Tories continually miss is that, in Scotland, we are committed to supporting active farming and food production. However, farming will have to adapt if we are to meet our net zero targets, and, indeed, farmers have the skills to do that. I ask the minister for examples of good practice that would see farmers become eligible under each of the tiers.
As briefly as possible, minister.
The new support framework that is being co-developed with partners will support farmers to take the opportunities that the transition presents and help to deliver our vision for agriculture. We continue to support and invest in our farmers and crofters and to take action on climate change through a range of initiatives, including Farming for a Better Climate, which is Scotland’s farm advisory service, the agricultural transformation fund, the knowledge transfer and innovation fund, the agriculture, biodiversity and climate change network and the integrating trees network. Through those initiatives, we continue to encourage the uptake of low-carbon farming practices by offering financial support and providing practical advice and guidance, supporting knowledge and skills transfer and demonstrating the climate and business benefits of taking action.
Food Insecurity and Food Poverty
To ask the Scottish Government what discussions it has had with food producers, manufacturers and distributors regarding supply chains and how to tackle food insecurity and food poverty. (S6O-02103)
The Scottish Government has regular engagement with food producers, manufacturers and distributors, including via the food sector resilience group and the retail industry leadership group. We also engage directly with third sector food groups such as FareShare that redistribute food for social good.
Although third sector groups are able to provide inclusive community activities, the Scottish Government believes that everyone should have the money that they need to access food with dignity and choice. As promised in our programme for government, we will soon publish our plan, which is grounded in human rights. It sets out the further action that we will take to improve the response to hardship and reduce the need for food banks.
I am grateful to the cabinet secretary for her response, and I am glad that she mentioned FareShare. We are seeing the highest rate of inflation in food prices for almost 50 years, and FareShare has reiterated the struggles that it is experiencing. As colleagues know, FareShare redistributes surplus food to charities and communities across the country, but it is seeing a reduction in what is available to it because of industry pressures.
Last year, the then Cabinet Secretary for Rural Affairs and Islands convened a summit on the issue. Will there be a follow up to that, and what more can the Government do to support charities such as FareShare?
I join Monica Lennon in commending the work that FareShare does, which, unfortunately, is still widely needed in our communities. She is right to point to the work that the cabinet secretary did in convening the summit. As part of my portfolio, I, too, am very interested in working with FareShare and other parts of the third sector to see what we can do to support it.
The important part—which I mentioned in my original answer—is our plan, which we are due to publish soon, to ensure that we are considering what can be done to support families and end the use of and need for food banks in Scotland. However, until we are at that stage, there is, unfortunately, a role for food banks and the work that FareShare does. I am happy to have further discussions with Monica Lennon about that, should she wish.
Yesterday, Humza Yousaf’s flimsy document failed to mention agriculture and farming, and it also failed to look at the significant potential for innovation and technology—such as genetic technology—that will play a vital role in decarbonising the industry, improving yields, improving reliability of crops and improving food security. Will the minister or the cabinet secretary reconsider their intransigent position on gene technology?
Strangely enough, I do not agree with the premise or the context that the member put on the document that was published yesterday or on the work that has been done by the Government on that more widely. I appreciate that there are different views on the issue, but the Government has made its views clear. [Interruption.] It is a shame that Rachael Hamilton is not listening to the answer to the question. Perhaps I will leave it there.
Livestock Worrying
To ask the Scottish Government whether it will provide an update on the steps that it is taking to tackle livestock worrying. (S6O-02104)
The Dogs (Protection of Livestock) (Amendment) (Scotland) Act 2021 has been in force for more than a year. It provides Police Scotland and the courts with greater powers to deal with people who allow their dogs to worry, attack or kill livestock in Scotland’s countryside. Increasing awareness is a key factor in the prevention of livestock-worrying incidents and associated unnecessary suffering. The Scottish outdoor access code is clear on the rights and responsibilities of land managers and people exercising access rights, and it is widely publicised.
More generally, in 2021, the Scottish Government delivered an awareness-raising digital campaign in partnership with the Scottish Society for the Prevention of Cruelty to Animals to promote responsible dog ownership. The campaign has been rerun on Facebook, Twitter and Instagram on a number of occasions. It directs the public to information about the law on controlling dogs on the mygov.scot website. The website makes it clear that dog owners are responsible for the actions of their dog, and it sets out potential penalties for failing to control dogs.
I am sure that the minister will be aware of the horrific attack on livestock on a farm near Kelty, in Fife, which resulted in the death of 20 lambs and more than £7,000-worth of damage. I note the minister’s responses, and I will come back to some of them.
Farmers in my region and across the whole of rural Scotland already have to deal with the stresses of the lambing season, and, although sentencing is a matter for the courts, I note that sentencing guidelines for a maximum fine of £40,000 and 12 months’ imprisonment, which were brought in in 2021, do not appear to have had the deterrent effect that they were meant to have. A survey that was conducted by NFU Mutual in February found that 29 per cent of respondents knew about the potential fine and 32 per cent of dog owners understood that they could be imprisoned if their pets went on to attack. What more will the Scottish Government do to prevent the mutilation of defenceless animals and protect farmers’ livelihoods?
I understand the strength of feeling about this. Any dog attack—even just one—is one too many. The worrying of livestock by dogs is completely unacceptable. As well as causing obvious suffering to the animals concerned, the damage that is inflicted on flocks and herds can have severe financial and psychological consequences for farmers.
Estimates from Police Scotland show that 262 cases were reported in 2022, which was down from 301 in 2021, while NFU Mutual estimated that the cost of dog attacks on Scotland’s livestock fell by almost by 31 per cent—almost a third—last year.
I am pleased to say that the situation is improving, and the member is correct in saying that, under the 2021 act, which was introduced by Emma Harper as a member’s bill, owners of dogs that attack or worry livestock can be fined up to £40,000 or face a prison sentence of up to 12 months. Currently, we do not have any data for the implementation of the law, because it is relatively new, but sentencing in any given case is a matter for the independent court within the overall legal framework.
We will have to move on to question 6, despite there being interest in supplementaries to this question. The responses will have to be briefer, and so, too, will the questions.
Comprehensive and Progressive Agreement for Trans-Pacific Partnership
To ask the Scottish Government what its response is, regarding agriculture and the food and drink industry in Scotland, to the comprehensive and progressive agreement for trans-Pacific partnership. (S6O-02105)
We are assessing the deal further and await more detail from the United Kingdom Government, although its own scoping assessments show that any benefits, including tariff reductions, will be limited, with a mere 0.08 per cent increase in UK gross domestic product.
Although there might be some growth opportunities for Scottish food and drink producers, those are very limited and there are significant risks, particularly for our sensitive agricultural products, which are set to be damaged by bilateral deals that the UK Government recently agreed with New Zealand and Australia. The former Secretary of State for Environment, Food and Rural Affairs has already criticised them as poor deals for the sector. It also remains unclear how the UK will protect domestic standards against the arbitration process of trading.
Sustain, the alliance for better food and farming, has said that the UK has joined a trade bloc in which food, farming and environmental standards are lower than our own. That raises concerns about the impact on consumer health and farm businesses in the UK. NFU Scotland and the Royal Society for the Prevention of Cruelty to Animals have also cited similar concerns about animal welfare standards. Does the minister share my concern that this deal represents another post-Brexit race to the bottom?
Minister—as briefly as possible.
I very much share those concerns. Scottish ministers continue to argue for a role in UK trade negotiations so that we can safeguard Scotland’s interests and watch out for such risks, because we believe that the UK is potentially joining a trade bloc in which many food, farming and environmental standards are significantly lower than our own, which is not a good road to go down.
Emissions Reduction Targets (Agriculture)
To ask the Scottish Government how it anticipates its proposed agriculture bill and future payments framework will support progress towards meeting Scotland’s emissions reduction targets. (S6O-02106)
Farmers, crofters and other land managers have a key role to play in meeting our climate targets. The new support framework, which is being co-developed with partners, will support them to take advantage of the opportunities around this transition and help to deliver our vision for agriculture. That vision makes clear our commitment to enable producers of high-quality food to deliver on our shared outcomes for biodiversity recovery and climate adaptation and mitigation. The next climate change plan, the draft of which is due this year, will include policies and proposals to ensure that the agriculture sector continues to play its part in meeting our ambitious net zero national target.
Integrating woodland into farms is a big opportunity for farmers across Scotland and for local environments. Will the minister set out how the new framework and revised forestry grant scheme will improve support to all farmers seeking to establish woodland on their land or on land that they manage?
Again, as briefly as possible, minister.
We are currently consulting on future grant support for forestry, which includes a specific question on how to better support farmers to establish trees on their farms. We look forward to hearing what stakeholders suggest. We envisage building on the principle of the recently introduced provision to include woodland creation as eligible activity in ecological focus areas.
We are actively promoting the integrating trees network—a farmer-led initiative that aims to encourage more farmers and crofters to plant trees and to raise awareness of the multiple benefits that planting trees can bring to agricultural businesses.
Seasonal Migrant Workers (Food and Drink Industry)
To ask the Scottish Government when it last engaged with the United Kingdom Government regarding access for Scotland’s food and drink industry to seasonal migrant workers. (S6O-02107)
The Scottish Government is clear that we need a migration policy that is tailored to the needs of Scotland’s economy, public services and communities. We need people to contribute at all levels of our economy.
However, the UK Government has repeatedly ignored calls from Scottish ministers for a workable immigration system that is fit for all sectors, including the food and drink industry. That is despite recent recommendations from independent researchers for the UK Government to closely involve Scottish agricultural representatives in shaping future policy and schemes. Clearly, UK Government policies are being implemented without a full understanding of their potentially catastrophic impact on rural and island communities. The UK Government must take a collaborative and evidenced-based approach to immigration policy before irreparable damage is done to our economy.
Key sectors in the industry are being left unable to access the workforce that they require and people who wish to come to Scotland to make a valued contribution. Brexit, being removed from the European Union and the end of freedom of movement have created barriers and are leaving our world-class food and drink industry hamstrung. Does the minister share my concerns about that? Will she continue to urge the UK Government to give an indication of how it intends to fix the mess that it has made?
As briefly as possible, please, minister.
Absolutely. The food and drink sector, like others, faces significant workforce recruitment and retention issues. Many of those issues are not new, but they have been exacerbated by the Covid-19 pandemic and Brexit. Many EU citizens have left the UK, resulting in a loss of skills that cannot be quickly and easily replaced.
On the matter of continuing to press the UK Government, the cabinet secretary has written to the UK Government repeatedly and will continue to do so. I hope that the member will support those calls.
That concludes portfolio questions on rural affairs and the islands.
Health and Social Care
The next portfolio is health and social care. There is a lot of interest, and I make the same plea for brevity in questions and responses. I hope that we will have a slightly more positive response. If a member wishes to ask a supplementary question, I invite them to press their request-to-speak button during the relevant question.
NHS Lanarkshire Public Health Annual Report 2021-22
To ask the Scottish Government what its response is to the NHS Lanarkshire annual report of the director of public health for 2021-22, which was published this March. (S6O-02108)
I welcome the NHS Lanarkshire public health annual report and the insights that it provides. It is encouraging to see the excellent initiatives that are under way and the renewed focus on health improvement. Persistent health inequalities remain, exacerbated by the cost of living crisis and the Covid pandemic. As the First Minister set out yesterday, the Scottish Government will support people with the greatest need, using every power available to protect the vulnerable. We will develop a sustainable health and social care system that ensures that people get the right care in the right place and at the right time, working with Cabinet colleagues to reduce poverty, prevent ill health and reduce health inequalities.
The report highlights the profound and disproportionate impact that Covid-19 has had on residents who are living in the most deprived areas of my constituency. As the minister said, that has been exacerbated by the current Tory cost of living crisis. Although the additional £1 million to directly fund general practice surgeries that are serving the most deprived patients across Greater Glasgow and Clyde is most welcome, will the minister consider extending vital targeted funding beyond the inclusion health action in general practice programme, specifically to Lanarkshire, where the burden of preventable long-term ill health is compounded by our proximity to Glasgow and the well-known Glasgow effect?
I thank Stephanie Callaghan for her important and insightful question. The First Minister’s vision for Scotland, “Equality, opportunity, community: New leadership - A fresh start”, which was published yesterday, reaffirmed the Government’s commitment to tackling the causes of health inequalities. Inclusion health action in general practice is a new programme that needs to be tested and evaluated. We have deliberately targeted 2023-24 funding at practices in NHS Greater Glasgow and Clyde because there is clear evidence that that is where we have the areas of greatest deprivation. We want to ensure that that new programme is effective and that we learn from its first full year. However, I will ask officials to explore future expansion of the programme to other areas of high deprivation, particularly Lanarkshire.
I welcome Jenny Minto to her new role.
Worryingly, the report also shows that the number of deaths from respiratory disease increased by nearly 8 per cent. Asthma and Lung UK has said that North Lanarkshire is an area in which people are more likely to die of lung disease compared with other parts of Scotland. Will the minister and her team discuss that with NHS Lanarkshire and let us know what action can be taken?
I thank Monica Lennon for her question on that important issue. I would like to give careful consideration to my answer. I appreciate that poverty remains a key driver of poor health in some areas. I will speak further with my officials and will respond to the member in writing.
Health and Social Care Budget Reductions (Glasgow)
To ask the Scottish Government what its response is to the reported £21 million of budget reductions for health and social care in Glasgow. (S6O-02109)
National health service funding is at record high levels, and the draft 2023-24 health budget provides more than £1 billion of support for social care, meaning that social care spending has increased by more than £800 million compared to 2021-22.
From a Scottish Government perspective, that is well ahead of our trajectory to increase spending by 25 per cent—£840 million—over the life of the Parliament, despite inadequate block grant funding from the United Kingdom Government. Our settlements from the UK Government have suffered a decade of austerity, with average real-term cuts of more than 5 per cent, equating to a loss of £18 billion. In the face of the UK Government’s cuts to our budget, we have protected councils’ budgets, providing more than £13.2 billion in 2023-24, which represents a cash increase of more than £570 million, or 4.5 per cent.
I thank the minister for that answer, but I feel that she cannot possibly be listening to trade unions or service users and constituents in Glasgow, whose quality of life depends on those services. The health and social care partnership is already long past the point of sustainable delivery, and now, according to its budget paper, it is likely to breach its statutory obligations to service users in the city. So, what is the Scottish National Party-Green Scottish Government going to do now to sort out the mess that Humza Yousaf has left behind in health and social care, and to properly fund and deliver the vital public services that the people of Glasgow need and deserve?
My starting point in all of these issues, which I am sure we would all agree with, is the people using social care services and the workforce delivering that vital care. We absolutely need to ensure that people are cared for in the best environment, which, in many cases, is in their home or within their own community. We are more than happy to meet the Convention of Scottish Local Authorities and provider representatives—we do so regularly—to understand the issues that they currently face, and we encourage and welcome open communication. We remain absolutely committed to establishing a national care service—which, I am sure, many in the chamber will agree will absolutely be the answer to the challenges that the member is raising—and we are continuing our work with our co-design process. Our overarching ambition remains to end the postcode lottery in care provision throughout Scotland through a national care service, as was recommended in the independent review of adult social care.
Lightburn hospital, in my constituency, offers significant additional step-down, step-up capacity, which has been proven to relieve the pressure on bed blocking in acute hospitals, as NHS Greater Glasgow and Clyde indicated to me in a letter, and to do so at far lower cost. Will the minister have discussions with the board to understand how best to maximise the use of that asset to clear bed blocking and help with waiting lists in a more cost-effective manner?
Again, my starting point is that we need to provide care for patients in the community, largely, but in the best place and the right place for them, and at the right time. I am more than happy to hear from the member the specifics of the case that he raises and will begin discussions with NHS Greater Glasgow and Clyde in order to find solutions to the challenges that it faces.
All over the country, we need to encourage flexibility in how we provide care in order to meet the needs of patients, who should be at the centre of all the decisions.
University Hospital Ayr
To ask the Scottish Government what its position is on reported potential reductions to bed numbers and the closure of a ward at University hospital Ayr. (S6O-02110)
NHS Ayrshire and Arran has been clear that the planned closure of beds relates to additional pandemic capacity across the system and that there are no plans to close core beds at either Ayr or Crosshouse hospital.
Five months ago, I wrote to Humza Yousaf to demand that services at Ayr hospital not be reduced. He replied that there were “absolutely no plans” to close surgical, intensive care unit or accident and emergency services. Now, however, it is reported that ward 10 in Ayr hospital may close, 75 beds could be cut and ICU beds are being moved to Crosshouse hospital. One senior national health service staff member described that move to me as “shocking”. It lets down NHS staff and puts patient safety at risk.
Can the cabinet secretary tell us why the First Minister has broken his promise to the people of Ayrshire?
First, we need to be careful not to conflate two different issues. The first issue is the surge capacity that was created during the pandemic. Ward 10 in Ayr hospital, which the member made reference to, was exactly that—surge capacity to deal with challenges during the pandemic. As boards across the country are going through that process, they no longer require that capacity and are, therefore, removing those particular facilities. That is exactly what is happening there. As has also been made very clear by the health board, core capacity remains the same.
The second issue that Sharon Dowey mentioned was in relation to the ICU beds. Members will be aware—as, I am sure, Ms Dowey is—that Ayrshire and Arran health board has put in place an interim arrangement to deal with the specific staffing issue of not being able to recruit a consultant to cover the ICU beds at Ayr hospital. I am sure that Ms Dowey will recognise that it is absolutely critical that beds of that nature have the right skilled medical cover to meet their needs. Those staffing challenges are exactly why the board has put in place that interim arrangement, which allows it to maintain its level of ICU beds across the health board area in a way that delivers the necessary quality of care and patient safety. It is important to recognise the staffing challenge for that board, which is exactly why it has had to put that interim arrangement in place, in order to facilitate safe patient care.
Jackie Baillie, who joins us online, has a supplementary question.
As the cabinet secretary has alluded, NHS Ayrshire and Arran announced that intensive care beds at Ayr hospital would transfer to Crosshouse hospital on an interim basis, but I have subsequently been contacted by staff who tell me that the transfer is to be made permanent and that, consequently, vascular and orthopaedic surgery have already moved, with more categories likely to follow. That is a significant service change, so can the cabinet secretary advise whether that is the case and why that has not been subject to public consultation? Can he also advise whether the process for consulting on major service change is being amended? If so, why has that not been made public—
I call the cabinet secretary.
The answer to Ms Baillie’s latter point is that there has been no change to that particular process. If the board was taking forward permanent changes, it would be required to undertake a full consultation exercise in order to do so. That is why the board has confirmed that the arrangements that it is putting in place are on an interim basis, because of its staffing challenges and desire to make sure that it continues the full complement of ICU beds on a basis of 24 hours a day, 365 days a year, across the board area. For the reasons that I have just mentioned, the board has had to put those interim arrangements in place.
Colin Smyth has a very brief supplementary question.
The A and E target at Ayr hospital has not been met for two years; delayed discharge in South Ayrshire has almost doubled in the past year; and NHS Ayrshire and Arran has reported capacity levels of 100 per cent at Ayr hospital. Will the cabinet secretary accept that those cuts in bed numbers are nothing to do with a lack of demand or need, but are due to a lack of funding? NHS Ayrshire and Arran’s deficit is set to double to an eye-watering £56 million this year.
As I have already mentioned—and I am sure that Colin Smyth heard me—the core bed capacity in NHS Ayrshire and Arran remains the same. Those surge capacity beds were put in place for the purpose of the pandemic. The health board has also made it very clear that the closure of those particular beds will be carried out in a safe, sequential manner over a period, as it manages its delayed discharges in order to see their reduction in the acute sector and moves towards more care support in the community. NHS Ayrshire and Arran has given an assurance that it will take that forward in an appropriate way, to make sure that quality of care is maintained going forward.
Health and Social Care Providers (Communication and Collaboration)
To ask the Scottish Government what steps are being taken to improve effective communication and collaboration between health and social care providers. (S6O-02111)
The Scottish Government is actively involved in many programmes of work that are designed to maximise the benefits of health and social care integration through effective communication and collaboration between all partners in the system.
Several proposals, which the ministerial strategic group for health and community care has brought forward, are concerned with collaborative leadership and building relationships. Much work has been done in that area in recent years, including training for integration joint board members, and engaging with stakeholders to support integration, foster collaboration and encourage the sharing of practice across the health and social care sector.
I thank the minister for her response and for outlining those areas.
I have been contacted by a number of constituents who have been discharged without an appropriate care package being in place. I have had cases relating to NHS Forth Valley and heard about experiences in other health boards such as NHS Lothian. Given the adverse impact that such discharges have on service users and their families, and the commitment to quality service integration, some of which she has already outlined, will the minister give more detail about the specific work that is being undertaken to reduce such instances?
I would be more than happy to look into any specific issues, if the member wishes to pass on the details to me. Although we absolutely recognise the pressures that are facing our health and social care system, individual discharge decisions should be undertaken by the relevant multidisciplinary teams to ensure that the appropriate care package, should it be required, is available, even if that is part of a discharge to assess decision. We are working very closely with the acute and social care system to ensure that best practice on discharge is embedded and sustained through our hospital occupancy and delayed discharge action plan, which was issued to partners last month.
Inclusion Health Action in General Practice
To ask the Scottish Government whether it will provide an update on the inclusion health action in general practice programme within the NHS Greater Glasgow and Clyde area. (S6O-02112)
In March 2023, as part of our efforts to improve the health outcomes of some of the most disadvantaged patients, we provided new inclusion health action in general practice funding of £300,000 to practices in NHS Greater Glasgow and Clyde with the highest levels of poverty and disadvantage. On 5 April, the First Minister announced a further £1 million of inclusion health action funding for this financial year. The funding enables practices to take practical action to tackle challenges that they and their patients face in relation to health inequalities.
Last month, the Progressive Economy Forum published findings that United Kingdom Government austerity policies have lost £540 billion in public spending since 2010, compounding the situation that was set out in research from the University of Glasgow, which showed that people across the UK are dying younger as a result of austerity, with people in the poorest areas being hardest hit. Over the past 200 years, there has been consistent improvement in mortality rates, up until 2012, when life expectancy reduced specifically for people living in poverty. Does the minister agree that that is completely unacceptable?
Many of the health inequalities that people suffer that result in premature death are a result of the social inequality that they experience. That social inequality is largely driven by financial inequality in our society. The research that the member referred to, which was by the University of Glasgow and, I think, the Glasgow Centre for Population Health, clearly highlights the close association between austerity policy and its impact on social inequality and then directly on health inequalities.
There is absolutely no doubt about the evidential link that exists between austerity policies that are being pursued by the UK Government and their direct impact on life expectancy. That is why the measures that we put in place to tackle public health must be closely linked to tackling social inequality, including the measures that were discussed in yesterday’s debate in the chamber and the measures that we can introduce to reduce child poverty, which are systematically undermined by austerity policies that are being pursued by the UK Government, which result in greater social inequality and reduced life expectancy.
Thank you, cabinet secretary—as briefly as possible.
As the academics have highlighted, there is a clear link between the austerity policies of the UK Government and their impact on life expectancy in Scotland.
I welcome the cabinet secretary to his new role.
Data from Public Health Scotland shows that the overall risk of developing cancer is 30 per cent higher in the most deprived areas of Scotland compared with the least deprived. That is just one example of deprived communities paying the harshest price of health inequalities. Data shows that cancer, drug deaths and alcohol-related admissions are all more prevalent in those areas. In his new role, how will the cabinet secretary prioritise prevention to tackle the root causes of the multitude of health inequalities that have occurred under his Government?
As briefly as possible, cabinet secretary.
The member raises a really important point, and I go back to the point that I made about social inequality being one of the major drivers of the health inequalities that we experience in our society. Some of the funding that we are providing for inclusion health action is about supporting the GP practices that are working with patients who have the poorest outcomes because of those social inequalities, to give them more time and support to work directly with that patient group. For example, in the deep-end practices, that additional capacity supports them in tackling some of the negative outcomes that patients experience as a result of public health challenges.
All the other public health measures that we are taking alongside that, including reducing smoking by promoting smoking cessation and ensuring that we are reducing the level of alcohol intake, play an important part. However, those measures can take us only so far, unless we tackle the endemic problem of social inequality, the root cause of which is austerity, which has been perpetrated by the Westminster colleagues of those on the Conservative benches.
Social Care (Unfilled Posts)
To ask the Scottish Government how many social care posts remain unfilled across Scotland. (S6O-02113)
The Scottish Government does not hold that information. There are more than 1,200 social care providers across Scotland, with local authorities responsible for providing or commissioning services. Local authorities and health and social care partnerships will wish to ensure that, in providing a range of services, their workforce planning arrangements take full account of the need to have safe and sustainable numbers of staff. The Scottish Social Services Council, as the regulator of social care services, publishes an annual report on vacancies in social services, which can be found on its website.
The fact is that nobody knows how many vacant posts there are across Scotland. Local authorities—I have made freedom of information requests to most of them—can tell us what vacant posts they have, but they cannot tell us about vacancies in the private sector.
Let us take Fife as an example, where more than 60 per cent of social care is provided by the private sector. Social care companies are struggling to recruit; they cannot recruit. How on earth will we tackle the problems when we do not know exactly what the problems are? Across Scotland, tens of thousands of older people need care packages, but they are unable to access them.
Does the minister agree that we must tackle poor pay? Does he agree that we must tackle the unacceptable terms and conditions of workers in the private sector?
Minister.
That is why we have got the problem.
Minister.
I agree with the member that we must tackle both pay and conditions to improve the situation in social care. Yesterday, I had an inspiring visit to a hub in Fife, where incredible work is going on. One of the things that I heard from those working there is the challenge of providing care in wealthy areas, where people who work in social care cannot afford to live. There are different challenges in different parts of the country, and this Government is determined to tackle every one of them.
On pay, we have already provided £100 million of additional funding to uplift pay for workers providing direct adult social care in commissioned services for this financial year. From April, those workers will see their pay increase to a minimum of £10.90 an hour, in line with the real living wage for the 2023-24 financial year. That represents a 14.7 per cent increase for those workers in the past two years, with pay rising from at least £9.50 an hour in April 2021 to £10.90 an hour in April 2023, and I guarantee that—
Thank you, minister. I want to get in a supplementary. I call Christine Grahame, whose question needs to be brief.
It is brief. What impact has Brexit had on staffing levels in the care sector?
I ask the minister to be similarly brief.
We are deeply concerned about the impact of exit from the European Union on the recruitment to critical front-line social care roles. The Scottish Government has always recognised the crucial importance of non-United Kingdom citizens to Scotland’s economy, to our society and to the delivery of our vital health and social care services.
The Scottish Government has provided funding to NHS Education for Scotland to lead the delivery of a programme of work to support social care providers to increase workforce capacity through international recruitment. The aim of the programme is to support social care providers to navigate the UK immigration system more easily and to have support available to alleviate some of that bureaucratic burden on the international recruitment—
Thank you. We move to question 7.
Child and Adolescent Mental Health Services (Outsourcing)
To ask the Scottish Government whether it will provide an update on how it is supporting national health service boards, including NHS Ayrshire and Arran, that have outsourced child and adolescent mental health services in order to reduce waiting times, to bring such services back in house. (S6O-02114)
The use of the independent sector has been an option open to all health boards to help address short-term capacity issues.
Through Scottish Government investment, we continue to engage and support boards, including NHS Ayrshire and Arran, to build their workforce and to implement the national CAMHS service specification. In 2021-22, the Scottish Government allocated around £40 million to improve CAMHS and neurodevelopmental services for children and young people, and, in 2022-23, we invested £32 million via the mental health outcomes framework to improve the quality and delivery of mental health and psychological services for all.
We are well aware of the pressures that health boards and CAMHS face, but the issues with long waiting lists are long-standing, and that is due to Scottish National Party inaction. Health boards are now having to outsource CAMHS to reduce waiting times. I would have expected the minister to commit Government to returning services in house.
Is the Government committed to supporting health boards to return those services in house? If so, what is the timetable for that?
As briefly as possible, minister.
I can assure the member that we are absolutely committed to improving in-house services. Part of tackling the backlog is the use of private services. We have allocated £32 million to improve the quality and delivery of mental health and psychological services for everyone. The priorities of the funding were to continue to deliver improvement in CAMHS and psychological therapies, eating disorder services and neurodevelopmental services, as well as on-going innovation and service reform.
I hope to be able to return to the chamber sometime soon to report positive progress.
We have a very brief supplementary from Tess White, who joins us online.
Does the minister think that the Strang report has been sufficiently implemented? If so, can she explain why waiting times for CAMHS treatment have gone backwards?
Please be brief, minister.
I can assure the member that largely across the country waiting times for CAMHS treatment are going in the right direction. In some places, because of the focus on tackling long waits, the number of people who are waiting beyond 18 weeks has extended, but I expect that to be a temporary challenge as the situation improves. As I have said, I expect to be able to report real progress to the Parliament very soon.
Patient Travel Schemes (Review)
To ask the Scottish Government when it will review the NHS Scotland patient travel scheme and the Highlands and Islands patient travel scheme. (S6O-02115)
The review is a substantial exercise for the Scottish Government and national health service boards and, regrettably, it remains delayed due to on-going prioritisation of the remobilisation of services. It will be taken forward as soon as possible, taking full account of the matters raised by members, including Ms Grant.
Financial support for travel remains available for patients and authorised escorts, according to eligibility criteria and medical requirements. Boards are expected to support patients to identify and access the support that is available, while taking into account individual circumstances and ensuring that patient care is at the centre of all decisions.
Patients can travel long distances to access healthcare, and it can be really expensive, especially if an overnight stay is necessary. At the moment, they can claim back £50 for an overnight stay, but budget rooms in Inverness can cost in excess of £400 in the summer. That means that constituents are cancelling treatment. They are also not able to take family with them because the criteria are unreasonable.
The situation is now urgent. Will the minister make it a high priority to review this as soon as possible?
As briefly as possible, minister.
I recognise exactly the issues that Ms Grant has raised, having experienced them myself and having many constituents who have experienced them. The Scottish Government continues to work with boards to limit the need for travel in the first place, where that is possible and clinically appropriate, especially by utilisation of the Near Me service. However, I understand the issues that she has raised, and I am happy to look into them.
That concludes portfolio questions. There will be a brief pause before we move to the next item of business, to allow front benches to change.