Rural Affairs, Land Reform and Islands
Good afternoon. The first item of business is portfolio question time, and the first portfolio is rural affairs, land reform and islands. I remind members that questions 4 and 6 are grouped together, and that I will take any supplementaries on those questions after both have been answered.
Crop Damage (Mitigation)
To ask the Scottish Government how it plans to mitigate against crop damage over the coming months. (S6O-03589)
I am very aware of the diverse range of challenges that farmers are currently facing. The Scottish Government places a very high priority on supporting farmers to mitigate against crop damage from a wide range of threats, notably from plant pests and disease, and in adapting to climate change.
The Plant Health Centre and the Farm Advisory Service are key elements of that support. We invest almost £50 million a year in-portfolio on strategic research in order to support advances in sustainable crop production, natural resources and the environment, including research that is aimed at improving crop resilience.
I thank the minister for his answer, but last year, Scotland’s farmers had to endure extreme drought, wildfires and a deluge of rain. The delayed start to planting this year has already alarmed farmers about the coming months. Considering the Scottish Government’s poor response last year, can farmers and local residents expect anything different this year?
Clearly, I disagree with what the member says—I think that the Scottish Government’s response was very good. I have already informed members that I hosted a flood resilience and water management round-table event with the sector earlier this year. The Government has already put in £1.8 million of flood support, which is available for flood bank repairs. There is on-going support and work with the industry, and this Government has a very good working relationship with the farming sector.
Rural Economy (Business Expansion)
To ask the Scottish Government what discussions the Cabinet Secretary for Rural Affairs, Land Reform and Islands has had with ministerial colleagues regarding action to support businesses in the rural economy to expand. (S6O-03590)
The Cabinet Secretary for Rural Affairs, Land Reform and Islands is committed to building a prosperous and inclusive rural community, and she meets—as I do—with ministerial colleagues to represent the interests of both rural businesses and communities.
For example, alongside the Deputy First Minister, the cabinet secretary co-chairs the rural delivery plan ministerial working group. That group was established to ensure that Government delivers for rural areas in a cohesive way, making best use of our collective resources to deliver sustainable outcomes for rural islands and rural coastal communities, including on economic development.
The minister will know that a recent survey from the Country Land and Business Association found that 73 per cent of businesses are losing thousands of pounds of investment, thanks to projects being held up by the planning process. I suggest that that is an issue not only in the rural sector, but elsewhere.
What is the Scottish Government doing to address that concern about the planning process?
The member raises a very good point, and planning is a matter that has been raised by members on all sides of the chamber. However, I go back to my point that we have a joint ministerial working group and we talk about these issues regularly. There are specific issues in the member’s region and in my constituency, of which we are very cognisant, and we are definitely working towards finding proper solutions for them.
We have a supplementary from Emma Roddick, who joins us online.
Does the minister agree that the Tories—just this once, before they are booted out the door—should be honest with rural businesses and communities, acknowledge the damage that they have caused and apologise for the barriers that they have created for businesses and the havoc that their policies have caused for Scotland’s rural economy?
Minister, if you can extract from that anything that falls within your jurisdiction and responsibility, please do so. Otherwise, please just do not bother.
The member is absolutely correct to say that we have a range of problems that have arisen for the rural community as a result of things that have happened via Westminster, Brexit being the obvious example, but I will leave the politics there for the moment.
Rural Depopulation (Effect of Agricultural Support)
To ask the Scottish Government what discussions the rural affairs secretary has had with ministerial colleagues regarding the potential link between agricultural support and rural depopulation. (S6O-03591)
In our vision for agriculture, rural communities can thrive and more people, not fewer, can live and work sustainably on our land. That is regularly discussed with ministerial colleagues. Through a phased approach, as outlined in our agricultural reform route map, future agricultural support will improve the resilience, efficiency and profitability of the sector.
I oversee the rural component of our addressing depopulation action plan, which strategically supports communities facing population decline. We will continue engagement with rural partners to deliver the right support, ensuring sustainable communities now and into the future.
Recent research by Scotland’s Rural College looked at the risks and opportunities for Orkney, Shetland and the Western Isles as a result of changes in agricultural policy and support. Although differences exist between each island group, all three boast high levels of environmental designations and priority habitats and species. In all three, agriculture accounts for a higher share of business activity and employment compared with Scotland as a whole, with a larger multiplier effect across the economy from any investment that is made. Given that and the challenges that are faced in sustaining populations and building community resilience, what commitment can the cabinet secretary give that future policy and support will reflect the findings of that research? Does she accept that what happens to farming and crofting matters to our islands economically, environmentally and socially?
The member raises a number of important points. I will first touch on the research element. The Scottish Crofting Federation raised that report with me, and I believe that it is due to be published shortly. As with anything, the more data, information and research that we have to help inform our policy decisions can only be a good thing.
I give the member the assurance that we will consider the report as we continue on our agricultural reform journey and continue developing policy. We will, of course, look to work closely with rural communities on the other elements that the member discusses. I absolutely recognise how important agriculture is to our rural communities, particularly our island communities, including the member’s constituency of Orkney.
In some parts of Scotland, people are farming and crofting in the most marginal and challenging of circumstances. Does the cabinet secretary share my concern that any undermining of Scotland’s ability to tailor agricultural payments to the specific needs of our sector could potentially render certain types of farming and crofting unviable and be a catalyst for people leaving agriculture and their communities? That is why it is vital that the devolved nature of agriculture is not undermined.
The member raises a critical point. Our ability to design support that works for our farmers, crofters and land managers in Scotland is critical. We have very particular types of support that do not exist elsewhere in the United Kingdom that recognise the type of land mass that we have in Scotland. An example that illustrates that is our less favoured area support scheme payments, which are critical for the people who work on our most marginal land. We had concerns throughout the passage of legislation such as the Subsidy Control Act 2022 and the United Kingdom Internal Market Act 2020 because of the threat of their potential to undermine our ability to develop policy that works for Scotland. That is why we will continue to develop policy here, by working with our farmers and crofters to deliver a future framework of support that will work for them.
Brexit (Food and Drink Exports)
To ask the Scottish Government what analysis it has undertaken to consider the impact that Brexit has had on Scottish food and drink exports. (S6O-03592)
The food and drink growth sector is a major contributor to Scotland’s economy and is Scotland’s biggest non-energy export. The sector continues to be impacted by a range of issues, including Brexit, with many parts of it suffering from lower exports to the European Union post-Brexit, including a 45 per cent fall in fruit and vegetable exports between 2019 and 2023.
Meat producers, seed potato growers and many other food manufacturers have been severely impacted by Brexit. Salmon Scotland revealed that Scotland lost up to £100 million a year in salmon exports to the EU because of Brexit. Unsurprisingly, the Westminster parties are too feart to talk about the damage caused by Brexit, so can the cabinet secretary assure me that the Scottish National Party Government will always highlight Brexit chaos, stand up for our food and drink industry and do everything possible to get Scotland back at the heart of Europe?
I assure the member on all those fronts. He raised some important points and identified critical industries for Scotland, not least seed potatoes, which are important for the north-east of Scotland.
Scotland is paying a high price for Brexit, which it did not vote for. The food and drink sector has undoubtedly been impacted, and the figures and costs that have been set out lay that situation bare. We have highlighted repeatedly to the United Kingdom Government the chaos that it has inflicted through its hard Brexit. We will continue to do that, and we will continue to stand up for our food and drink industry.
It is astonishing that neither the Tories, Labour nor the Liberal Democrats are arguing to reverse Brexit. I agree with the member that the only way that we can escape this economic disaster is for Scotland to become an independent country and an equal member of the European Union.
Brexit (Food and Drink Exports)
To ask the Scottish Government when it last met the United Kingdom Government to discuss the impact of Brexit on Scotland’s food and drink exports. (S6O-03594)
The Scottish Government has taken every opportunity to engage with the UK Government to press it on the impact of Brexit on Scotland’s food and drink sector. The formal mechanism for that is the interministerial group for environment, food and rural affairs, which last met on 13 September 2023. Unfortunately, the group has not met since, as United Kingdom Government ministers have pulled out of subsequent meetings. There are also regular meetings at official level that cover a range of post-Brexit issues that have an impact on Scotland’s food and drink sector.
The outgoing UK Government imposed a deeply damaging and costly Brexit on my constituents and on the economy. Given that the academic think tank, UK in a Changing Europe, said that Labour’s EU plan will have a “minimal” impact on the cost of Brexit, I am glad that the cabinet secretary agrees that only real change from the disaster of Brexit will come when Scotland becomes an independent country with full membership of the EU.
There is overwhelming evidence that the UK Government’s irrational hard Brexit continues to cause significant economic damage to Scotland and, indeed, to the whole UK. For example, in May this year, the Institute of Directors said that 46 per cent of its members were finding EU trade challenging, and that 57 per cent of its members who import or export were identifying new customs regulations as the key problem. Therefore, I completely agree with Marie McNair that the only way forward is for Scotland to become an independent country with full membership of the EU.
I remind members of my declaration of interests as part of a family farming partnership that grows crops and produces beef.
Exports to the European Union of British beef are banned because of bluetongue, which only came into the country through Europe. Does the minister think that the EU—where bluetongue is rife—is right to ban imports from UK countries?
Edward Mountain has raised an important point. It is vital that we take action on all fronts to try to prevent the importation of such diseases, which is why the engagement that we have had with the UK Government on the border target operating model has been frustrating. We originally agreed to endorse that model because we need to take whatever action we can to prevent importation of diseases such as the one that Edward Mountain mentioned. However, there has been a severe lack of engagement from the UK Government in relation to that and in relation to our west coast and qualifying Northern Ireland goods. The member might wish to raise that issue with his colleagues in the UK Government and ask them to engage with us constructively on those matters, so that we can try to address them.
Small Producers Pilot Fund
To ask the Scottish Government whether it will provide further details of how the small producers pilot fund has supported microbusinesses in Scotland. (S6O-03593)
We are utterly committed to small producers, and the pilot is only the first step towards that commitment, limited, as it is, by our present powers and capabilities. The fund was developed in partnership with the industry that Emma Roddick referred to. She will be aware that, earlier this year, the Cabinet Secretary for Rural Affairs, Land Reform and Islands confirmed £1 million resource funding.
So far, we have supported two small-scale abattoir projects and development of the small producer information hub website, and we are currently in the process of procuring a practical training fund, all of which support small producers.
I am aware of the £180,000 that was awarded last year through the fund. As the minister mentioned, among the project awards was support for two mobile abattoirs. Many people in my region are keen that those become normal sites for agricultural workers, who often struggle to travel to Dingwall or Mull—journeys that often include multiple ferries and/or lengthy road trips for farmers and their animals. Is the Scottish Government considering further support for such schemes?
Emma Roddick has raised a very important point. The cabinet secretary publicly directed that the pilot steering group explore solutions to challenges regarding accessibility to abattoirs and regarding sufficient throughput. An abattoir survey was conducted and has been published. I am happy to share that with the member.
Continued support for abattoirs will be considered for this financial year, following the review of the funding to date, and we will continue to work with smaller producers to ensure that the right support for their needs is developed with them. The pilot is a step towards ensuring that the essential role of that cohort is recognised and rewarded appropriately.
Distribution of support funding is disproportionately targeted at large farms. The £1 million funding pot actually equates to £143 per year for the small producers that are registered. Large farms receive £223 per hectare per animal, which shows the discrepancy in the funding. What action is the Scottish Government taking to ensure fair distribution of support?
As I said in my answer to the previous question, it is a pilot fund and the Scottish Government has absolutely committed—as we have just been through the passage of the Agriculture and Rural Communities (Scotland) Bill—to working with small producers to make sure that they get the absolute maximum possible support through development of the programme.
Cetacean Deaths (Fishing Line Entanglements)
To ask the Scottish Government what discussions it has had with the Scottish Association for Marine Science regarding its research into reducing the deaths of cetaceans from fishing line entanglements. (S6O-03595)
The Scottish Government is aware of the research into entanglement in creel lines of sensitive marine species and we are currently considering the findings of the research. We welcome the support from fishers to trial solutions to reduce such entanglement events, and we welcome the role of SAMS in the work. We are fully committed to tackling the issue and will, through the future catching policy, be working with stakeholders to deliver action to reduce—and, where possible, eliminate—bycatch and entanglement of sensitive marine species, as part of a wider effort to ensure the sustainability of our fisheries.
Creeling is a low-impact form of fishing. However, rope that is used to connect the creels is causing an ever-greater number of cetaceans, including porpoises, humpback whales and minke whales, as well as basking sharks, to drown after being entangled. A trial of sinking ground line, which is only slightly heavier than standard rope, with creel boats that are operated around the north-west Highlands, has proved to be a simple and effective method of reducing the risk of entanglement in static gear. Therefore, will the Scottish Government explore facilitating wider roll-out of sinking ground line across the static-gear fleet to ensure that Scotland retains its position as a European leader in marine mammal conservation?
First, I thank Kenneth Gibson for mentioning the research, because we are always interested when it comes to such research reports and their findings and will be giving it our full consideration.
I have just mentioned our future catching policy. As part of our discussions on it, we will arrange a stakeholder workshop on sensitive species bycatch, this summer. We will use that meeting as an opportunity to discuss the findings of the report with the industry.
Our vision for fisheries in Scotland has sustainable management at its heart, and we support good practice by the fishing industry. We are really pleased to see the level of support from fishers to trial solutions that will reduce marine animal entanglements as part of the project.
Kenneth Gibson is right to highlight the work on trialling solutions to prevent cetacean deaths. Entanglement also poses risks to seabirds such as gannets and is a danger to shipping. Damage from ghost fishing gear to the propeller of the NorthLink freight vessel MV Helliar recently took her out of the lifeline service for weeks. What efforts are being made by the Scottish Government to prevent ghost fishing gear and thereby reduce entanglements, which are a danger to sea life, fishing and shipping?
Beatrice Wishart has made some really important points. In relation to seabirds, we have the seabird conservation strategy: work is on-going in that regard. In relation to discarded fishing gear, we are currently supporting the development of a European standard for recyclability and circularity for fishing and aquaculture gear. The standard will provide guidance and encourage designers, makers and users to adopt best practice and available technologies in order to ensure that fishing gear stays in use for as long as possible. That includes its retrieval in the event that gear is lost.
We are part of a number of important initiatives to help to tackle the problem, including the Global Ghost Gear Initiative and KIMO International’s Fishing for Litter initiative, to promote behaviour change. I hope that we are, by supporting such projects and by undertaking advances in other areas, as I have set out, taking a rounded approach to trying to get to grips with the problems.
National Register of Ancient Woodland
To ask the Scottish Government when it plans to deliver on its commitment to produce a national register of ancient woodland. (S6O-03596)
A new national register of ancient woodland is an important element of the Scottish biodiversity strategy and delivery plan, which we consulted on last year. We have been discussing with NatureScot and Scottish Forestry the best approach to developing a new register of ancient woodland, which will build on the existing Scottish ancient woodland inventory.
I thank the cabinet secretary for her answer, but she did not say when the Government plans to deliver that register. I accept that there have been talks and consultations, but if we are to be able to protect and restore our ancient woodland, we need to know where it is, how much of it there is and what condition it is in. I urge the cabinet secretary to have another go at the original question and to tell me when we will see a national register.
Graham Simpson has raised some important points. I completely understand and agree with him about the importance of the work. I recognise and admit that it has not progressed as quickly as any of us would have liked it to progress, which I fully appreciate, because the work that we have been taking forward has been focused on the biodiversity strategy and its delivery plan. That work has been very complex, because it involves a range of organisations that have interests in delivery of the strategy.
I am completely aware of the importance of providing a national register of ancient woodland and I offer the assurance, now that we are through the first stage of the strategy and are moving into the delivery phase, that that work will be prioritised in order to help us to ensure that our important ancient woodlands are protected. I would be more than happy to keep Graham Simpson informed, as we progress that work.
That concludes portfolio questions on rural affairs, land reform and Islands. I was unable to take questions from a few members, but they were not here for the start of the question session. There will be a short pause before we move on to the next item of business.
NHS Recovery, Health and Social Care
The next item of business is portfolio questions on national health service recovery, health and social care. I make the usual plea for those who want to ask a supplementary question to press their request-to-speak button during the relevant question.
Moray Maternity Services
To ask the Scottish Government, in the light of reports that capital expenditure work has now been stopped at Raigmore hospital, when it will publish its plan for the Moray maternity services redesign. (S6O-03597)
On 3 March 2023, the Scottish Government approved the plan that NHS Grampian and NHS Highland submitted for the reintroduction of obstetric maternity services at Dr Gray’s hospital, which was backed by up to £6.6 million of Scottish Government investment. We remain committed to that plan. NHS Grampian has a dedicated Moray maternity web page, where it publishes its regular newsletter, which it shares with the public and local elected members. The March edition of the newsletter included a summary of the plan and a working timeline.
As the minister well knows, all capital works have stopped, and maternity provision across the Highlands, especially for Caithness mothers, is shocking. Given that NHS Highland has already spent £2.7 million on the project, and it has potentially overspent by £70 million, surely the Government must accept that the handling of the Moray maternity services redesign has been shambolic and nothing short of wicked.
With regard to Moray maternity services at Dr Gray’s, I am pleased to say that NHS Grampian and NHS Highland have moved forward with delivery of the plan. In addition to the delivery of the first three milestones, three obstetricians and one paediatrician have recently been appointed, recruitment of specialist midwives, anaesthetists and speciality midwives is on-going, expansion of the day-case assessment provision is continuing and operating models for neonatal care and intrapartum obstetric care are being finalised. Work is absolutely continuing, and I regularly meet my officials, who regularly meet NHS Grampian, to discuss progress.
Regarding capital works, the United Kingdom Government’s decision to cut the Scottish Government’s capital budget for the next five years by nearly 9 per cent in real terms has had a severe impact on healthcare projects. Can the minister advise of any conversations that have been held with the UK Government on that matter? Will she join me in calling on the UK Government to reverse those harsh cuts, to ensure that Scotland’s health service infrastructure can be significantly improved?
I agree that it is incredibly disappointing that the Scottish Government’s capital budget was reduced. As Ms Harper said, our block grant for capital is expected to reduce by around 9 per cent in real terms by 2027. That represents a cumulative loss of more than £1.3 billion.
Ahead of the UK autumn statement in November and the UK spring budget in March, the Cabinet Secretary for Finance and Local Government called on the UK Government to reverse the cuts and to provide clarity on the future of our financial transactions funding. Sadly, no clarity and no additional capital or financial transactions funding for Scotland was forthcoming.
Question 2 has been withdrawn.
University Hospital Wishaw (Neonatal Intensive Care)
To ask the Scottish Government whether it will proceed with its reported plans to downgrade the neonatal intensive care unit at University hospital Wishaw. (S6O-03599)
The decision to move to three neonatal intensive care units has been made on the basis of clinical evidence that tells us that that change will improve outcomes for the very smallest and sickest babies. As I agreed to do when I met Monica Lennon and Wishaw constituents in November, I have considered again the data and evidence in relation to the proposals and have taken additional advice from clinical advisers who were not part of the best start process for identifying the location of the units, and I am reassured about the validity of the evidence base, the process and the conclusions that were reached.
The Scottish Government-commissioned independent modelling report was published on 29 May. Following consideration of that report, we have asked the regional chief executives to progress with the development of implementation plans.
The Scottish Government is now consulting families on implementation of the proposals, so that we can take account of their concerns when the pathways and processes for the new model of care are designed. An online survey is being developed, and that will be followed by the use of targeted focus groups, to help us to listen to the concerns of parents in Scotland and to inform implementation plans.
The minister will know that almost 23,000 people have signed a petition that urges the Scottish Government to stop the downgrading of Lanarkshire’s neonatal intensive care unit. It is important that my constituents believe that their voices are being heard.
The Scottish Government says that parents are key partners in the care of their babies and that we should do everything possible to keep mothers and babies together. That said, how can the Scottish Government continue with the devastating downgrading plans, when ignoring the pleas to save the Wishaw neonatal intensive care unit would force families to be apart at a vulnerable and critical time?
The new model of care is firmly based on clinical evidence, as recommended by a group of neonatal experts. To ensure that babies and parents remain close, we have the young patients family fund, which will support people. The hospitals that will host the intensive neonatal care units will have suitable accommodation alongside the units, to ensure that that important bonding happens. That is all part of the plans that we are asking the national health service health boards to work through to ensure that we achieve the best results.
It is welcome that the local neonatal units will continue to offer care for the vast majority of babies, including a level of neonatal intensive care. For clarity, will the minister reaffirm that the plans are about ensuring that, with pre-emptive planning, the smallest babies are born where they can readily access the specialist care and services that they might need, including neonatal surgery, which is not currently available at Wishaw, and that that is in line with expert clinicians’ advice?
I reaffirm that the new model of care is recommended by a group of neonatal experts and is firmly based on clinical advice, which shows that the most preterm and sickest babies do best when they are cared for in larger, specialist neonatal units, which look after a lot of those babies and have specialist staff and services available on site to give them the very best care. We are doing that to give babies who are born at the extremes of prematurity the best chance of survival. I believe that that is what every parent wants for their baby.
Martin Whitfield has a brief supplementary question.
Will the minister confirm whether the clinical analysis and advice that she was given is about what is right for the baby, the baby and the mother, or the family?
The advice that I have received is from experts on looking after babies in a neonatal care situation. That advice has always looked at the baby in the round, and that is why we continue to ensure that I get the right advice from the right groups of people to move the work forward.
Health and Social Care Services (Impact of Inflation)
To ask the Scottish Government what assessment it has made of the impact of inflation on health and social care services in Scotland. (S6O-03600)
Spiralling United Kingdom inflation has had a devastating impact on all public services, including health and social care. In spite of that, we have provided more than £19.5 billion for the health and social care budget, which gives our national health service a real-terms uplift.
Despite that investment, the system is under extreme pressure as a result of the on-going impacts of Covid, Brexit, inflation and the UK Government’s spending decisions. Therefore, hard choices, greater efficiencies and savings will need to be made. We regularly assess inflation and the impact on health and social care services, and that features in the development of the Scottish public sector pay policy.
Later this summer, we will publish our health and social care portfolio medium-term financial framework, which sets out expected inflation levels, linked to the gross domestic product deflator rates, and that will be updated annually as new information becomes available.
Not just inflation but years of UK Government spending cuts have continued to have a detrimental impact on the Scottish Government’s ability to provide the level of funding that our health and social care services deserve. The cabinet secretary highlighted the impact of the UK Government cuts to our budget. Does he envisage that we can protect our public services, such as the NHS, from increased privatisation and future cuts?
Gordon MacDonald is right—a decade and a half of Tory austerity has had a clear impact, and it is becoming harder and harder for us to continue to mitigate that. The UK Government has ignored the calls from this Government to prioritise investment in public services and infrastructure. Although I welcome the additional resource funding that was received at the spring budget, the £237 million that was provided is only around half of the £470 million of consequentials from 2023-24, which have not been baselined in full into 2024-25.
That is clearly a disappointing situation, which sets a challenging fiscal context. It also serves to illustrate the continued short change that the Labour Party has offered, of just £134 million in additional health funding for the Scottish Government.
The UK Government’s figures show that Department of Health and Social Care funding for 2024-25 is 0.2 per cent less in real terms than it was in 2023-24, while we have provided a real-terms increase of 3 per cent. That is just one example from a resource perspective. I could also point to the capital side and show why Wes Streeting was absolutely right when he said that the pressures in Wales are because
“all roads ... lead ... to Westminster”.
Question 5 is from Bob Doris, who joins us remotely.
Baby and Child Immunisation Programmes (Uptake)
To ask the Scottish Government whether it will provide an update on the levels of uptake for baby and child immunisation programmes, including any emerging trends. (S6O-03601)
Quarterly and annual childhood immunisation rates across Scotland remain high, which reflects the hard work and commitment of our colleagues in the national health service and the recognition of the benefits of vaccination. However, there have been decreases in uptake compared with previous years—a trend that has been observed globally.
We are working with Public Health Scotland and health boards to improve vaccination uptake, address health inequalities and support those who are eligible for vaccination. We urge parents and guardians of young children, when invited, to bring them for vaccination in order to give them the best protection against serious disease.
The sharp increase in whooping cough cases, with 3,650 cases confirmed in the first half of 2024 in Scotland and, sadly, deaths in England, highlights the vital importance of childhood vaccinations, as well as—in this case—vaccinations for pregnant mums. More generally, vaccinations offer protection from a variety of dangerous conditions. Although immunisation rates remain high, as pointed out by the minister, they are dipping. Will the Scottish Government outline how it seeks to ensure that we maintain high levels of uptake across society, including, for instance, in lower-income areas in my constituency of Maryhill and Springburn and among groups with a history of vaccine hesitancy?
This morning, I met representatives of the Scottish vaccination improvement programme, which is a partnership between Public Health Scotland, health boards and the Scottish Government. We were talking about exactly that—the importance of vaccination as one of the most effective public health interventions that we can make throughout our population.
As Mr Doris highlighted, an increase in cases of pertussis illustrates the importance of health boards continuing to promote the benefits of vaccines and ensuring that access to vaccines is straightforward, timely and equitable. Public Health Scotland has developed a range of social media toolkits and has translated advice into a number of languages to support that work, and it is working with health boards and the available data to target efforts where they are most needed—for example, in areas of deprivation, where uptake might be lower.
As I have said, parents and guardians also have a vital role by bringing children forward for immunisation when they are called, to ensure that they get the best protection. We as elected members can also promote that.
There are a couple of supplementary questions. I will try to get them both in, but they will need to be brief, as will the responses.
It is known that immunisation rates are lower among those living in more deprived areas and in black and minority ethnic communities because of various factors, including a lack of trust and a lack of information. What measures is the Scottish Government taking to increase uptake of vaccines by those groups?
Mr Choudhury raises a very important point. Although not specifically with regard to vaccinations, I have met BME communities with regard to organ donation and such like. I shared that at the meeting that I was at this morning.
It is incredibly important that we reach all groups. As I said in response to Mr Doris’s question, our social media content has been translated into a number of languages.
My question is in a similar vein to my colleague Foysol Choudhury’s question on the more likely lower vaccination rate in more deprived areas. I am interested in knowing whether the minister thinks that we could do more cross portfolio to ensure that uptake in those areas reaches the level that exists across the rest of Scotland.
I agree with Carol Mochan that there is work to be done, and we are working cross portfolio to improve healthcare in areas that face inequalities. I would be happy to work not only cross portfolio but cross chamber and to meet Ms Mochan and Mr Choudhury to discuss the matter further.
Scottish Ambulance Service (Scheduled Care Transport)
To ask the Scottish Government what action it is taking to ensure that scheduled care transport provided by the Scottish Ambulance Service is accessible to all patients who need it. (S6O-03602)
The Scottish Government recognises that transport plays a key role in supporting patients’ health journeys, and it prepared the transport to health delivery plan in summer 2023. The plan outlines 16 commitments across health and social care and for Transport Scotland.
The Scottish Ambulance Service plays a key role in supporting patients to access healthcare appointments. It carries out a needs-based assessment for each patient to determine eligibility for clinical support during transfer to appointments. The assessment helps to ensure that the transport service is available to all those patients who need it.
I raise that question because, in recent months, quite a number of constituents have told me about their difficulty in accessing transport services. For example, one lady from Fife who had to attend Edinburgh for radiotherapy was told that she did not meet the eligibility criteria. The woman, who was in her 80s, was told to use public transport. Each leg of the journey would have meant taking three buses. She physically was not able to do that. Will the minister look at such issues? Has the eligibility criteria been changed? The woman being told that she was not eligible because the criteria had changed came as a shock to her cancer nurse. Is that simply a case of cuts by the back door?
I thank Alex Rowley for raising that incredibly serious issue, especially as we represent rural communities, where people need to be able to access healthcare services in an equitable fashion. We must ensure that our patient transport system works effectively.
To directly address his last question: no, it is not. It is obvious that the Scottish Ambulance Service continually reviews patient eligibility. It is right that it does so, as patients’ eligibility will change based on their fluctuating circumstances. However, it is also right that the Scottish Ambulance Service takes into account the patient’s condition and bases its decision on that.
I do not have the full details of the case that Mr Rowley raises, but I am concerned about it. I ask for more detail to allow me to interrogate the matter further, so as to ensure that people can equitably access the healthcare services that we want to be delivered to them.
I want to ask the cabinet secretary about the access to and the availability of the patient transport online booking service. The service has been and continues to be well used, but, as we have already heard, there are logjams in the system and the service is experiencing difficulty in fulfilling all bookings in some parts of the country. Will the cabinet secretary comment on that?
That is not a situation that I have had communicated to me as yet. If Mr Stewart has particular examples with which he would wish to furnish me so that I can investigate further, I would be happy to do so and reply in writing on the basis of the findings.
Ambulance Turnaround Times
To ask the Scottish Government whether it will provide an update on what action it is taking to tackle long ambulance turnaround times. (S6O-03603)
The Scottish Ambulance Service continually engages with health boards, while optimising services including flow navigation centres and the integrated clinical hubs, which provide care for patients at or near home, reducing pressure on accident and emergency departments.
The call before you convey protocol is being used and cohorting areas have been established at sites that are facing challenges, ensuring that ambulance crews are freed up during high-demand periods.
People in the north-east were shocked to read reports of a 96-year-old woman waiting outside Aberdeen royal infirmary for nine hours due to ambulance stacking. By the time that she was admitted, she had not eaten for 14 hours. We must be clear that everyone from the ambulance crew to the hospital staff did their jobs well, but the turnaround times that they are expected to work with, which are already unacceptable, are becoming unbelievable.
After 17 years of the Scottish National Party being in charge of our national health service, what is the cabinet secretary doing specifically at the ARI to prevent stacking? Does he think that it is acceptable to have elderly patients starving and in agony for hours with help just out of reach?
Clearly, the example that Liam Kerr cites is unacceptable. There is no defending that, and I apologise to the patient and their family for the situation that they have endured.
On the direct action that we are taking with NHS Grampian on the pressures in the ARI, I have asked for an improvement plan that will address the pressures in the accident and emergency department and throughout the hospital. There are pressures not just for our ambulance service in accessing the hospital but for the flow through the hospital.
We are also taking direct action with a joint mission with the Convention of Scottish Local Authorities on reducing delayed discharge, because our hospital occupancy across Scotland is too high, and that is stopping the flow through the hospital.
It is also fair to say that ambulance stacking is not a unique phenomenon, either to the ARI or to Scotland. Further, the situation is faced elsewhere in the United Kingdom. That is not to say that it is okay to experience that in Scotland; it is just reflective of the fact that there are significant pressures on our health and social care services across the UK—
Thank you, cabinet secretary. I want to get in a supplementary question.
Can the cabinet secretary confirm that, despite fiscal constraints as a result of Westminster Tory cuts, the Scottish Government provided £349.2 million to the Scottish Ambulance Service this year, which is an increase of £15 million on the previous year? Will he provide details of how that funding will be used to recruit additional staff to increase capacity and improve the service?
The Scottish Government recognises the extreme pressure that the system is under, as a result of the on-going impacts of Covid, Brexit and inflation, as well as the UK Government’s spending decisions. We have therefore provided almost £550 million of additional investment to front-line NHS boards as part of the 2024-25 Scottish budget.
The Scottish Ambulance Service received £15 million of that increased investment, taking its funding to nearly £350 million to support the delivery of its services, and we continue to invest in the Scottish Ambulance Service workforce. We have provided funding of £45 million on a recurring basis in 2023-24 to support increases in the board’s capacity. That includes funding for the recruitment of 1,388 additional staff since 2020, 230 of whom were recruited in 2023-24.
Child and Adolescent Mental Health Services (NHS Fife)
To ask the Scottish Government what action it is taking to reduce waiting times for CAMHS in NHS Fife. (S6O-03604)
We continually monitor CAMHS waiting times performance, engage with all boards—including NHS Fife—and direct tailored support to the boards with the longest waits, providing access to professional advice.
In recent months, NHS Fife has made improvements in its waiting list for CAMHS. Between June 2023 and the end of March 2024, when the latest statistics were published, there was a 25 per cent decrease in the waiting list and a 41 per cent decrease in the number of patients who wait more than 18 weeks. That is to the credit of the staff in Fife, who should be commended for their hard work in achieving that.
Boards were allocated £55.5 million in 2023-24 via the mental health outcomes framework to improve the quality and delivery of mental health services, including CAMHS, in addition to the core funding that health boards receive.
I thank the cabinet secretary for that response, and I know that he is highlighting improvements, but there is a mental health crisis among our young people. The Scottish Government has repeatedly pledged action, but, when we look at the other stats, we see that nothing has changed.
NHS Fife’s latest data, from March 2024, shows that there are still 41 young people waiting up to 35 weeks for a follow-up appointment following a referral; that figure has barely moved from the 47 young people who were waiting for more than 35 weeks in March last year. Even more worrying is the fact that, during the same period, 31 per cent of referrals were rejected altogether, leaving many to seek help from charities, and that is almost identical to the 33 per cent that was recorded in the previous year.
What is the question?
That is another year gone by. When will the Scottish Government stop promising and actually do something?
I thank Roz McCall for her question and for the attention that she is putting on the importance of the investment that we are making in child and adolescent mental health services. We have increased investment and we have increased support through the workforce.
On the figures that Roz McCall quoted of those who are waiting 19 to 35 weeks, that number was 70 in June 2023, and it was 41 in March this year. Clearly, for the people who are waiting that length of time, that is not acceptable, but we are seeing an improvement in those services. It is not fair to say that the decisions that we have taken have had no impact. They are having an impact.
It is also not fair to say that having their referral rejected means that there is no help or support for those children. As a specialist service, CAMHS will be the right support for only a small proportion of children and young people. The national CAMHS specification includes a clear expectation that children and young people whose referral is not accepted are sensitively and appropriately signposted to more suitable services.
We are investing and we are making improvements. I want to see those improvements happen faster, which is why—
I will take a very brief supplementary question. It will need to be brief, as will the response.
The Psychotherapy and Counselling Union met me today and raised the point that there are often no other routes of referral apart from CAMHS. Loading pressure on to CAMHS is part of a vicious cycle, which includes cuts to mental health spending across the board in community settings, primary care settings and educational settings. Is that not compounding the pressure that we are seeing, not just in CAMHS but across our mental health services and the NHS?
There has been no cut to mental health services—I do not know where Paul Sweeney is getting that from. There has been a substantial increase—a near doubling—in the funding that is available for mental health, and a clear investment has been made in CAMHS. That is why there is an increase in the workforce supporting CAMHS referrals and why there is better referral-to-treatment performance. It is not where we want it to be, but it is the best performance that we have had in a decade.
I am very grateful to the front-line staff who are working so hard and performing so well to ensure that we are providing those services to the children and young people who need them.
That concludes portfolio questions on NHS recovery. There will be a brief pause before we move to the next item of business.