General Practitioners (Rural and Remote Practices)
To ask the Scottish Government what it is doing to help recruit and retain GPs in rural and remote practices. (S4O-03377)
The Scottish Government is working with NHS Highland to promote a range of initiatives to recruit and support GPs working in remote and rural areas throughout Scotland. Recruiting GPs into remote and rural locations is always a difficult task, and we completely understand the frustration that the issue is causing in local communities that are without a permanent GP.
One strand of work, which is supported by £1.5 million of funding from the Scottish Government over four years, is to develop and test innovative ways of delivering healthcare in rural Scotland. The traditional approach to recruitment has not been successful, so as part of that work we are developing, with the support of a marketing expert, a bespoke recruitment exercise, which will be in place by the summer.
I have met several GPs in my constituency of Aberdeenshire West who are concerned about their work overload because of the ageing population and that medical students will not come through the system to replace the GPs who are coming up for retirement. What can be done to alleviate that issue?
National recruitment data shows that recruitment into GP training remains high, with a 92 per cent fill rate. The Cabinet Secretary for Education and Lifelong Learning, Michael Russell, and I recently agreed to increase the number of trainees and specifically to encourage people who live in rural areas to enrol in medical school. There is clear international evidence that people who come from rural areas tend to go back to those areas to live and work once their training is completed.
We are tackling the problem, and I recognise the issues. Many communities, particularly the remoter ones, have particular problems. We are working with the Royal College of General Practitioners, the British Medical Association, the health boards and a range of other people to try to address the problem. I should, however, remind members that the number of GPs per head in Scotland is actually the highest by far in the whole of the United Kingdom.
Does the cabinet secretary agree that using cash incentives to attract GPs to rural and remote practices has had only a limited effect in the pilots that have taken place and that drastic measures will have to be taken to counter the worrying trends across rural Scotland? What action will he take to create a level playing field between dispensing doctors and pharmacies in rural areas?
On that latter point, the member will be aware that I have laid regulations in relation to dispensing GPs to try to deal with the situation. If there is an application for a new pharmacy in a rural area, the wider consequences of approving that application, particularly for GP facilities, will have to be considered as part of a board’s decision on whether to accept the application. I suggest that the member read those regulations, which have been laid before Parliament and which I intend to implement at the earliest possible opportunity once Parliament has approved them.
On the challenge of recruiting GPs to rural areas, the issue is not primarily about financial incentives, because we have tried such incentives. The key issue is work-life balance. Very often it is not the GP’s concern about moving to a rural area but family pressure that prevents a GP from moving to or staying in a rural area. I am particularly conscious of the issue in areas such as west Lochaber, in the Highlands, where we have done everything possible to recruit GPs. I cannot force GPs to go and live and work permanently in a particular location.
As I said, we recognise the problem, which is not confined to Scotland, and we are trying to address it in innovative ways, including the extended use of telehealth facilities. For example, in Kilchoan, people have direct access to consultancy services at Aberdeen royal infirmary.
Private Educational Establishments (Rates Relief)
To ask the Scottish Government how many private educational establishments are entitled to 80 per cent mandatory rates relief and how many are given relief of up to 100 per cent. (S4O-03378)
Currently, charities, including educational establishments, that are registered with the Office of the Scottish Charity Regulator are entitled to receive 80 per cent mandatory relief, which a local authority may decide to top up to 100 per cent. Data on the number of private educational establishments in receipt of relief and what percentage of relief they receive are not held centrally.
Figures from the Scottish Parliament information centre show that in Edinburgh over the past three years about £5 million of mandatory relief has been given. Given that public resources are scarce, that money should not be going to the pampered and the privileged. Does the minister agree that that £5 million would be better spent on public services for the many? Will he work with colleagues to ensure that mandatory rates relief is removed from social elites?
The decision about what constitutes a charity comes down to OSCR, not ministers. There has been a rolling review of all private schools in Scotland; of the 39 schools that OSCR examined recently, 35 passed the charity test, two failed and subsequently passed the test after changes, and two are still being considered. Those are very much questions for OSCR and are not matters for Government intervention.
School Buildings (Inspection)
To ask the Scottish Government whether it will review the remit of Education Scotland school inspections to include the condition of school buildings. (S4O-03379)
School inspections aim to answer three questions: how well young people learn and achieve; how well the school supports young people to develop and learn; and how well the school improves the quality of its work.
Local authorities have responsibility for health and safety and the structural condition of buildings. Although Education Scotland does not inspect the structural aspects of a school, if it becomes aware of a health and safety issue during an inspection it follows up the issue with the school and the local authority to ensure that it is addressed. National guidance is provided to assist local authorities in assessing the condition of their school estate.
The minister will know that the Cabinet Secretary for Education and Lifelong Learning rightly asked local authorities to review their school estate in light of the tragic accident at Liberton high school. He will also know that this week Audit Scotland flagged up that there is concern in relation to 18 per cent of the school estate. Does he agree that there is a strong case to ensure that there is formal consideration of the condition of school buildings when it comes to school inspections?
I think that the whole Parliament agrees that we must learn lessons from the tragedy at Liberton. The member will be aware that there is not a great deal more that I can say about the case, given the on-going investigations.
It is important to say that local authorities are best placed to assess the condition of schools. It is significant that, notwithstanding everything that the member said, the proportion of pupils who are in schools that have been categorised as having poor or bad buildings has dropped from 37 per cent in 2007 to 16 per cent now. We are not complacent about that, but I suggest that the figures indicate that there have been substantial achievements.
Public Buildings (Heating Systems)
To ask the Scottish Government what flexibility there is in the national calculation method for determining the type of heating system used in large public buildings. (S4O-03380)
The national calculation methodology for non-domestic buildings currently includes flexibility for 24 types of heating, ventilation and air-conditioning system, which can be used to provide heating in all types of non-domestic building, including large public buildings.
As the minister might be aware, Orkney hit the 100 per cent renewables target seven years early last year. That has required innovation and has tested the existing grid’s capacity. It has also exposed regulatory obstacles that might hamper achievement of that 100 per cent target.
Will the minister therefore commit to look at potential derogations to existing planning requirements to enable renewably generated electricity to be used more extensively? Will he agree to consult his colleagues Fergus Ewing and the health secretary to see how commercial and community schemes that are looking to supply Orkney’s heating load during the coming years, particularly that of the new hospital, can be facilitated?
Yes, I will accede to that very reasonable request from Mr McArthur and I will explore all options. I will instruct officials to consider the detail and potential flexibility that might well exist to proceed with the agenda in light of Mr McArthur’s comments. We have to bear in mind that there are some legislative and regulatory requirements that we have to stick within, but we will be as flexible as we can to deliver the desired outcome.
Independence (Intelligence Agency)
To ask the Scottish Government how the single intelligence agency it proposes to create in an independent Scotland would protect citizens from unjustified surveillance. (S4O-03381)
As indicated in “Scotland’s Future”, striking the right balance between maintaining the constitutional and human rights of our citizens and the need for national security will be vital. For the first time, there will be democratic governance and accountability of national security matters in Scotland by a Scottish Government and Scottish Parliament. Early legislation will set out the purpose, duties and powers of a Scottish security and intelligence agency and the controls that will exist on the use of those powers.
The Government’s white paper talks about necessary co-operation with the United Kingdom security agencies. It also says:
“some of the work undertaken by security and intelligence agencies means, by necessity, interference with the privacy of specific individuals.”
Following revelations from the private sector and Charles Farr, the UK Government’s own senior security official, we now know that that is not what the UK agencies undertake. They are clearly undertaking mass, uncontrolled surveillance of the entire population of innocent citizens.
Can the Scottish Government give a clear undertaking that it will take the privacy of innocent citizens seriously and that agencies, policies, co-operation agreements and infrastructure will be designed in such a manner that we do not repeat this mass surveillance of the entire population?
Yes, I can give that assurance. We will ensure that we enshrine that within the constitution that provides rights for the individual citizen. There will not only be commissioners, but such agencies will be subject to parliamentary scrutiny.
It appears to me that we require to strike a balance between the rights of the individual and the rights of the wider community. Certainly, issues of serious and organised crime come before me and are dealt with by Police Scotland, and we have the appropriate balance and proportionality of scrutiny.
We have to ensure that that also applies when we have full powers because the issue of rights will be of even greater magnitude. However, we can give that assurance. We strike the right balance with serious and organised crime and the other aspects of intrusion that are dealt with in Scotland by Police Scotland and other agencies.
Ahead of any changes that have been suggested by the cabinet secretary that might occur, does he have any evidence that suggests that surveillance is being conducted by any police or other organisation in breach of the law?
As I said in response to Patrick Harvie’s initial question, I am aware only of matters that relate to serious and organised crime. Terrorism is reserved, so such issues go to the Home Secretary and do not come to me.
I believe that issues of serious and organised crime are dealt with appropriately. I deal with the commissioner and Police Scotland and I think that the correct balance has been struck. I cannot, however, comment on the concerns raised by Patrick Harvie about terrorism because neither myself as the justice secretary nor any other member of the Government in Scotland is entitled to receive that information. It all goes to the south.
NHS Lanarkshire (Meetings)
To ask the Scottish Government when the Cabinet Secretary for Health and Wellbeing last met the chief executive of NHS Lanarkshire and what was discussed. (S4O-03382)
Ministers and officials regularly meet the chief executives of all health boards, including NHS Lanarkshire, to discuss matters of importance to local people.
Surely the cabinet secretary must understand or at least admit that on his watch NHS Lanarkshire has moved from crisis to crisis, with waiting times, negligence payments and other indicators among Scotland’s worst; investigations into neonatal deaths and mortality rates; and 12 consultants and other senior staff maligned by the health secretary and so-called experts.
Is it not time that the cabinet secretary took the advice from the front of Tuesday’s Daily Record to get a grip by setting up an independent inspection system able to investigate proactively every aspect of the NHS in Lanarkshire and Scotland and able to tackle problems as soon as they are flagged up, rather than waiting a year before taking action?
We already have an independent inspection system in Scotland. The neonatal unit at Wishaw general hospital was independently inspected and the inspection showed that a very high standard of care is present in that unit.
I hope that the member will join me in condemning the comments made yesterday in this chamber by Johann Lamont, who said:
“you would be best advised not to give birth to a child in Wishaw.”—[Official Report, 18 June 2014; c 32393.]
That was a slur on the professionalism of every dedicated doctor, every dedicated midwife and every dedicated nurse in the neonatal unit and the maternity unit at Wishaw general hospital. Johann Lamont and John Pentland should hang their heads in shame at their attacks on the workers in the national health service.
The cabinet secretary will of course be aware that NHS Lanarkshire has now created dedicated on-site hospital management teams. Does he feel that that will contribute to improvement in patient care and, indeed, in patient and visitor confidence that their local hospitals work for them? Will he take up my invitation to visit Hairmyres hospital to check how the new system is working in practice?
The NHS Lanarkshire review highlighted the need to reform the management system within NHS Lanarkshire. I think that the new system that has been introduced will be much more effective in dealing with issues that need to be dealt with and the challenges in serving the people of Lanarkshire. It is early days yet, but in the three hospitals we now have a tripartite site management team, with a site director, a head nurse who is effectively like the matron used to be in older days, and the senior clinician in each of the three acute sites.
I am more than happy to visit Hairmyres with Linda Fabiani. I have already visited Monklands twice. I had the pleasure of cutting the sod on the £22 million new Lanarkshire Beatson centre last week. I note that no member of the Opposition, other than the Conservative Margaret Mitchell, welcomed that £22 million investment in NHS Lanarkshire.
Local Government Concordat (Waste Collections)
To ask the Scottish Government whether it considers that the number of missed bin collections over the last two years is evidence of the failure of its concordat with local government. (S4O-03383)
No, we do not. Our concordat with local government has set out the terms of the new relationship based on mutual trust and partnership. Councils have the freedom to focus on local concerns while contributing to the achievement of better national outcomes. It is for councils to ensure that they carry out their duties effectively and efficiently, including on waste and recycling. The Accounts Commission arranges audits of councils to help ensure that they are delivering effectively and provide best value.
I thank the minister for his answer and I understand what he is trying to say. However, surely the complexity and diversity of the recycling system, with multicoloured bins, people putting them out on the wrong days, bins remaining unemptied and missed collections, is evidence of a failing in the system of recycling. Would it not have been at least one legacy of the historic concordat if the Scottish Government and local government could have worked together to end that confusion?
I advise Mr Johnstone that Tory councils, as few as they are, miss bin collections from time to time as well. If it was not the concordat, I thought maybe the Conservatives would have thought that it was the constitution getting in the way of bin collections.
In reality, we have hit record recycling levels, we are meeting the zero-waste strategy targets, and recycling rates are up. Let us put matters into perspective. The bins continue to be collected, all the more because of the fantastic financial package and protection that Scottish local authorities get from the Government. That is quite different from south of the border, which has the worst of all worlds: council tax rises, reductions in services and—
I think that we get the message, Mr Mackay.
So the concordat continues.
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