Rural Affairs, Land Reform and Islands
Good afternoon, colleagues. The first item of business is portfolio question time, and the first portfolio is rural affairs, land reform and islands. I invite members who wish to ask a supplementary question to press their request-to-speak button during the relevant question.
Question 1 has been withdrawn.
Agriculture Bill (Views of Ayrshire Farmers)
To ask the Scottish Government how it will take account of the views of Ayrshire farmers as part of its proposed agriculture bill. (S6O-02393)
In the autumn of last year, in preparation for the agriculture bill, we ran a wide-ranging series of consultation events across Scotland to listen to the views of stakeholders and members of the public. Those events included a well-attended event in Ayr, at which Ayrshire farmers and producers shared their views on what needs to feature in the draft bill in order to ensure that the future adaptive framework can respond to social, economic and environmental changes, challenges and opportunities.
I recently met Ayrshire farmers in Kilmarnock and heard about some of their issues as well as their hopes for the new agriculture bill. One of their recurring concerns is that they feel powerless to influence the behaviour of the supermarkets when it comes to getting fair prices for their quality products.
Does the cabinet secretary recognise that? Although we have no powers in that regard, would she be willing to meet the farmers—perhaps at some point over the summer—to hear directly from them about their concerns and to hear their suggestions on how such matters could be taken forward?
I would be more than happy to engage with Willie Coffey and to meet farmers in his constituency. I absolutely recognise the importance of the issue that he has raised, which is one that is repeatedly raised with me in my capacity as cabinet secretary by different producers as I travel across Scotland.
I look forward to the engagement that I will have over the next few days through the Royal Highland Show. In addition, I have been in touch with supermarkets directly to have conversations about the issue with them. Willie Coffey will undoubtedly be aware that the issue was raised by the food security and supply task force that we had last year. One of the recommendations in the task force’s report was about engaging with the Competition and Markets Authority and the Groceries Code Adjudicator to raise such issues.
It is better for the climate to use home-grown produce than it is to fly in costly imports, with their associated food miles emissions. Local food is high quality and is produced to high environmental standards. Buying local also helps Ayrshire farmers to keep producing the first-class food that they are renowned for. The Scottish Conservatives have a plan for that as part of our sustainable food future policy. Will the agriculture bill learn from our policy and help to encourage more people and organisations in Ayrshire to buy good local food?
We will need to have briefer supplementaries and briefer answers.
I will try to be as brief as possible, Deputy Presiding Officer.
I absolutely agree with the points that Sharon Dowey has made about the importance of supporting our local producers and having short and resilient supply chains. That is why it is unfortunate that her party, through the United Kingdom Government, has signed us up to trade deals that will result in imports that undercut our industry in Scotland.
On a recent visit to Meinside farm, near Lockerbie, the message from farmers, once again, was that the uncertainty over future funding mechanisms is causing significant concern. When will the agriculture bill be published? Will it provide details of what will be expected of farmers in order to secure that funding in future? The uncertainty about that is a major concern.
First, I make the point—which is one that I have made previously in the chamber—that there will be no cliff edges when it comes to support for our farmers.
With regard to when the agriculture bill will be introduced, in line with the commitments that I have already outlined, we aim to introduce it this year.
In relation to clarity on the future direction of support, it is important to highlight to Colin Smyth and to other members across the chamber the existence of our “Agricultural Reform Route Map”, which outlines when the key changes will come forward and when we will provide more information and detail on those. I encourage Colin Smyth to take a look at that route map, which we will, of course, update as we proceed.
Muirburn (Prevention and Control of Wildfires)
To ask the Scottish Government what its position is on whether muirburn is a crucial tool for preventing and controlling wildfires. (S6O-02394)
I am aware of the recent devastation caused by wildfires. The Cabinet Secretary for Rural Affairs, Land Reform and Islands recently visited a site at Daviot to thank forestry staff, firefighters and the local community for their work tackling wildfires. Sadly, the risk of wildfires in Scotland is likely to increase with climate change. We must continue to tackle the issue and encourage people to behave responsibly when outdoors.
Muirburn can make a significant contribution to the prevention and control of wildfires. Our Wildlife Management and Muirburn (Scotland) Bill includes provisions that permit muirburn to prevent and reduce the risk of wildfires.
Professor Heinemeyer of the University of York has been studying peatlands for two decades. Regarding ways to prevent wildfires, he said:
“you come across a lot of ‘rewetting will solve all the issues’. But it’s not guaranteed. You can’t get a wet bog everywhere because of different rainfall amounts. That is wishful thinking.”
If we want down-to-earth thinking that will prevent wildfires and protect peatland and the species that live in an area, muirburn must be an important tool in our land management inventory.
I recognise that the minister said that there will be some muirburn. Can she confirm that the muirburn bill will not regulate the practice to be the last resort, which would risk the damage of unnecessary wildfires?
I agree with a lot of what Roz McCall has said, and I can confirm again, if she would like me to, that we recognise that licensing muirburn will allow it to take place, particularly in areas where it mitigates the risk of wildfire.
Peatland is also a tool that we have in our box to control wildfires, not just from the point of view of climate change and sequestering carbon, but with regard to the provision of areas where burning will be controlled because of wet peatland and re-established peatland.
I have a number of supplementaries, which will need to be brief, as will responses.
Given the seriousness of recent wildfires and the impact that that has had on forestry staff and fire officers, shame on the Tories for turning the issue into a political football. The Scottish Government has already stated that there are situations in which muirburn is the best option. Can the minister confirm that the Government is seeking to ensure that muirburn is used only where appropriate and that best practice is followed?
I appreciate that there is a range of views on muirburn. As I said in my response to Roz McCall, I am completely aware that muirburn can be a positive tool when used appropriately, in creating beneficial habitats for certain species, helping to reduce fuel loads, and lowering and controlling the risk of wildfires.
The introduction of muirburn licensing, through the Wildlife Management and Muirburn (Scotland) Bill, will ensure that muirburn is undertaken in a safe and environmentally sustainable manner, in line with best practice. The licensing scheme will allow muirburn for a number of purposes, including preventing or reducing the risk of wildfires.
Upland management is very important, particularly for public health, but also for biodiversity. Will Asulox be approved in Scotland? That is an urgent matter.
I do not think that that is relevant to muirburn. I will move on to Murdo Fraser.
I was going to ask a similar question. Clearly, dry bracken is a major contributor to the risk of wildfire, which is the topic of the question. When will the use of Asulox to control bracken be permitted in Scotland, given that permission for its use was given in England last week?
Minister, is there anything that you can add to what you have already said?
No, there is not. I made my point on the licensing of muirburn, and I will stick with that.
Beaver Relocation (Impact on Farmers)
To ask the Scottish Government what discussions the rural affairs secretary has had with ministerial colleagues regarding the reported concerns of farmers about the potential impact on their productivity of beaver relocation. (S6O-02395)
The reintroduction of beavers brings clear benefits for our biodiversity and ecosystems. However, I understand that beavers can have adverse impacts on some types of agriculture. I have not met ministerial colleagues, including the Cabinet Secretary for Rural Affairs, Land Reform and Islands, to discuss that particular issue.
NatureScot has a range of mitigation measures to help to protect farms, and there are arrangements that allow lethal control of animals as a last resort. Additionally, all translocation projects must follow the process in the Scottish code for conservation translocations, including appropriate engagement with the people who are most likely to be affected.
Beaver numbers are expected to rise to 10,000 before the end of the decade. That is clearly a cause for concern for farmers, who are justifiably worried about the threat that beavers pose to their land, given the evidence that they cause significant and costly agricultural damage should they appear in the wrong areas.
Back in 2019, the then environment secretary, Roseanna Cunningham, gave an assurance that Scottish farming would not be compromised by beavers. What mitigation does the Government intend for those who have already been affected by beaver damage? How will relocated beavers be managed to avoid unnecessary damage to farmland in the areas to which they are relocated?
Our Scottish beaver strategy, which was developed in partnership with stakeholders including NFU Scotland and Scottish Land & Estates, provides the direction of travel for beaver management in Scotland. The Scottish code for conservation translocations sets out the consultation process for proposed projects and ensures that those who are likely to be affected by proposals can have their views heard.
NatureScot’s beaver management scheme is integral to our work on managing beaver impacts. The scheme provides farmers and other land managers with mitigation advice, including proactive measures to prevent beaver impacts. Those include tree protection and the installation of flow devices and beaver exclusion fencing.
Although we consider lethal control to be a last resort, licensing approaches are available to prevent serious damage where mitigation cannot resolve conflict.
I remind members of my entry in the register of members’ interests, which relates to farming and fishing on Speyside.
Beavers do not just damage crops; they damage trees, too. Given that the Government again missed its tree-planting targets last year, how does the minister propose to protect important young riparian trees that are being planted to mitigate damage caused by beaver reintroductions? Please do not suggest wrapping them in plastic, minister.
As I set out in my previous answer, our beaver strategy, which outlines the direction of travel for beaver management in Scotland, has been developed with more than 50 stakeholders that have worked towards it, including the Scottish Wildlife Trust, NFUS and Scottish Land & Estates. They have collaborated on the strategy’s aims, which are in line with the Government’s aims. The strategy also sets out the importance of community engagement in achieving those aims. As I have previously set out, the installation of protection for valuable trees is part of our beaver mitigation measures, which we will continue to support as we move forward.
New Entrants into Agriculture
To ask the Scottish Government what measures it has put in place to support new entrants into agriculture. (S6O-02396)
The Scottish Government continues to invest in new entrants and the rural workforce. Since 2015, we have granted in excess of £28 million through a combination of national reserve, start-up and capital grant schemes.
Additionally, we have provided 122 land opportunities through the farming opportunities for new entrants programme group and have supported more than 82 joint ventures through the Scottish Land Matching Service. We continue to offer a range of general and bespoke consultancy advice to new entrants through the Farm Advisory Service. We are also pleased to support the machinery ring pre-apprenticeship programme to create opportunities for young people in rural areas.
That is helpful, but the cabinet secretary will be aware that several large corporate entities are buying up large tracts of property for forestry in order to meet climate change targets. That means that substantial areas of land are being taken out of agricultural use at a time when we desperately need food security. That is concerning my constituents in Perthshire, who have raised the matter with me on the basis that it also deters new entrants into agriculture. What will the Scottish Government do to address such concerns?
I am aware of those concerns, and Liz Smith has raised an important point. One factor that we see coming through the forestry grants scheme is that about 80 per cent of applications to it are for smaller pieces of land and small farms.
We want to ensure that we are putting the right trees in the right places. There is a strong role for both forestry and agriculture, including through agroforestry. We have an integrating trees network, which shows how we can combine those aspects.
The member also raised a critical point about our food security. As with many of the issues that we discuss in the chamber, our approach needs to be about ensuring that we get the balance right. We want to continue to see integrated land use, which has benefits not only for our environment but for our farming businesses.
Can the cabinet secretary confirm how much funding the Scottish Government has provided for new entrants and young farmers since 2015 and how that compares with other nations of the United Kingdom?
The Scottish Government has invested considerable sums for new entrants during the course of a number of years. Since 2015, we have provided just over £7-million worth of support via direct payments. We have provided around £12 million through the young farmers start-up grant as well as £600,000 for the new entrants start-up grant. It is important to highlight that those forms of support for new entrants were discontinued in England.
Given the contributions that new people in the sector can make to both food security and biodiversity loss, what additional measures can the Scottish Government take on retention of new crofting and agriculture entrants?
The member raised a very important point. We committed in our manifesto to providing new-entrant support, and it is important that we learn from the schemes that we have had in the past.
I was delighted to attend one of the farming opportunities for new entrants groups in Bute last week. It was interesting to hear from the farmers directly, and from the young farmers who were there, about some of the challenges that they faced in getting those opportunities. We want to ensure that we are breaking down barriers and providing opportunities.
I am keen that we learn from schemes that we have had in the past as we look to develop new support.
Wildlife Crime Investigation Powers (Report)
To ask the Scottish Government when the report by the taskforce to consider whether to extend wildlife crime investigation powers to the Scottish SPCA will be published. (S6O-02397)
The report provided by the Scottish SPCA task force has been published on the Scottish Government web pages this morning. I thank the task force for conducting the review and producing its final report. I will be providing a response to the recommendations in the report in due course.
On Monday, I had the pleasure of joining the Scottish raptor study group to visit red kite nests. The conversation centred around the importance of red kite conservation. However, the team also highlighted incidents of raptor persecution—a practice that I am sure we all condemn.
The SSPCA faces financial difficulties at present, and I am concerned that, should the Scottish Government not fund the organisation correctly, officers will be stretched when trying to fulfil their duties. That would include investigation powers should the bill be approved by Parliament. What reassurance can the minister provide that she will ensure that the SSPCA is fully supported?
I appreciate everything that Meghan Gallacher said about raptor persecution, and I agree with an awful lot of her concerns. The SSPCA is not Government funded, but Scottish Government officials regularly meet the SSPCA to discuss current issues and to provide support, when appropriate. Like many charities, its income comes from other means—including membership, fundraising and legacy donations among other things. We will do everything that we can, in consultation with the SSPCA, to ensure that it is supported to carry out any duties, should we decide to give them to the SSPCA.
Barriers under existing powers mean that SSPCA inspectors who are already on the ground investigating animal abuse are prevented from seizing and securing evidence of wildlife-related crimes, and inspectors are further limited to enforcing powers only on living animals, with their hands tied if a wild animal is found dead. Does the minister agree that that is inexcusable, and will she close the loopholes during future stages of the Wildlife Management and Muirburn (Scotland) Bill?
Mark Ruskell will know, because I was on the same committee as him during the previous session, that we heard exactly that kind of concern being raised about SSPCA officers not being able to act in certain situations when they found that there had been animal cruelty—particularly in situations involving wildlife.
The report that has been published today outlines what the SSPCA says that it can do. I am open to ideas about what we can do to support it to do that and close those loopholes.
Land Assembly Powers (Public Bodies)
To ask the Scottish Government whether it will introduce compulsory sales orders through its proposed land reform bill, in light of its plans to address the need for effective, efficient and fair land assembly powers for public bodies, as referred to in the Bute house agreement. (S6O-02398)
We recognise the importance of effective, efficient and fair land assembly powers for public bodies. That is why we are committed to reviewing compulsory purchase order powers to ensure that they remain fit for purpose. In 2023-24, we will appoint an expert advisory panel to inform the development of options for reform.
Work on the introduction of compulsory sales orders was undertaken in the previous parliamentary session and it will be considered more fully in this one, too.
It is encouraging that, this year, the Scottish Government is investing £10 million in projects to tackle the waste of derelict land, such as the decontamination and redevelopment of former military land at Cromarty Firth so that affordable homes can be built.
However, given the exceptional demand and skyrocketing prices for land right now, we must make better use of the 9,500 hectares of land that is currently benefiting neither people nor nature. Does the cabinet secretary agree that compulsory sales orders for councils to auction long-neglected land are a necessary tool for ensuring that the people of Scotland are getting the most out of their land?
In my initial response, I mentioned the work that would be undertaken on compulsory purchase orders. Councils already have such tools, which they are using to repurpose land for the benefit of local communities and their local areas.
However, as I have highlighted, we are considering how the introduction of compulsory sales orders might enhance the tools that are already available to local authorities. We will continue to engage with our stakeholders on that in order to really understand the need for those orders and to discuss the issues that were identified when the matter was initially raised, during the previous parliamentary session. Ultimately, that also has to include how any introduction of compulsory sales orders might comply with the European convention on human rights.
The Bute house agreement also refers to applying a public interest test to transfers of large-scale landholdings, but very few large landholdings are transferred in Scotland each year. Does the minister agree that waiting for all large landholdings to be transferred will take decades and that we need a public interest test that applies to existing holdings?
The member will, no doubt, be aware that we published the results of our consultation on our proposals for legislation a couple of weeks ago. We will be considering the views that have been expressed through that consultation as we develop our proposals for a land reform bill, which we will be looking to introduce soon. I look forward to working with the member and discussing the issues that have arisen from that as we take forward the work on the bill, which will look to address the issues.
If the Scottish Government takes the proposal forward, can the minister confirm whether, in the event of a compulsory sale, the new landowner will be required to put the land to the use that it is designed for? If so, can she explain how that will be enforced?
It is not possible for me to set that out at the moment because, as I have said, although the issue was considered in the previous parliamentary session, a lot of work still needs to be undertaken in relation to that. However, we would of course look to bottom out some of the issues that the member has raised.
Crofting Law (Reform)
To ask the Scottish Government whether it will provide an update on its plans to reform crofting law. (S6O-02399)
As stated in the Scottish policy prospectus, I am committed to the reform of crofting law by 2026, subject to agreement by Parliament, to support the future of crofting.
The crofting bill group has made good progress, since it was reinstated in May 2022, and it has reached a consensus on many topics. The group is considering the issues raised by the bill group in 2016 to 2018; the issues that the Law Society of Scotland singled out for a crofting law reform project in 2020; and the issues identified by the Crofting Commission to make crofting regulation less onerous for crofters and the commission.
A range of issues daily highlight the need for crofting law reform, not least the issue of common grazings. Given that crofting law expert Sir Crispin Agnew has noted that the current law is inadequate to manage subsidy regimes, environmental obligations and renewables opportunities, can the minister say whether the legislation will deal with those issues—in particular, in relation to common grazings?
As is stated in the 2021 manifesto, work on crofting law reform will be undertaken during this parliamentary session and a decision on the timing of the bill will be taken by the Cabinet in the context of setting out future legislative programmes in the normal way.
Mr Allan will know that the crofting bill group is looking at a wide range of issues to inform that draft bill, and we have asked the group to look at how we can make crofting legislation more relevant to modern crofting. Some of the things that he has mentioned are under consideration, and one of the issues being considered by the crofting bill group in its work on crofting law reform is common grazings.
That concludes portfolio questions on rural affairs, land reform and islands. There will be a brief pause before we move on to the next portfolio to allow members on the front benches to change.
NHS Recovery, Health and Social Care
The next portfolio is national health service recovery, health and social care. Members who wish to ask supplementary questions should press their request-to-speak buttons during the relevant question. We have a lot of interest in asking supplementaries, but we are due to sit late this evening and have no time in hand. Questions will, therefore, need to be brief, as will responses.
Surgery Waiting List (Pelvic Organ Prolapse)
To ask the Scottish Government how many women are currently waiting for surgical treatment for a pelvic organ prolapse. (S6O-02400)
Information on the number of patients waiting for pelvic organ prolapse surgery is not held centrally by the Scottish Government.
However, we are keen to ensure that those patients are seen as soon as possible, so we are working with the centre for sustainable delivery to adopt a national approach to expediting waits for a range of urogynaecology treatments, and work has started on that with the relevant health boards.
The minister might recognise some of the cases that I have raised in the chamber, including one of an eight-and-a-half year wait for one woman in my region. I have since been contacted by another two women, one of whom has been waiting 14 years for surgery. I am very keen to understand from the minister whether that is a national situation or one that pertains only to Tayside. If the minister could commit to looking into the matter, that would be appreciated.
First, I apologise to the women who have had those experiences. I will check with my officials to find out what information we hold and will get back to Michael Marra. I absolutely commit to doing that.
Dermatology Services (Investment)
To ask the Scottish Government what impact it anticipates that its recent £1.8 million investment will have on dermatology services. (S6O-02401)
The new programme, which enables primary care teams to send digital images of a patient’s skin condition to specialists, with the potential for up to 90 per cent of referrals to include a digital image, could reduce demand for outpatient dermatology appointments by up to 50 per cent.
That will lead to a better and quicker service for patients, allowing clinicians to see patients in the right place and sooner. Modernising our services with such innovations supports patient care, reduces pressure on our workforce and is absolutely vital for the future of our healthcare service.
Such innovations in our national health service are, indeed, welcome.
I have a specific question about topical corticosteroid treatments for inflammatory skin conditions. Although those are generally safe and effective in the short term, a number of my constituents have experienced withdrawal reactions after using those creams for longer periods. They describe a range of symptoms including burning or stinging, intense itching, peeling skin and skin redness extending beyond the area that was originally treated. The physical and emotional impact can be devastating.
Can the minister confirm whether there will be a key focus on reducing the number of patients using topical corticosteroids for prolonged periods while the work to improve treatment pathways continues?
Having spoken with some people who are affected by that, I recognise the impact that topical steroid creams can have. That is why we are bringing in that new way of working. By capturing images in primary care and enabling triage in secondary care, the programme will support timely access for patients who need secondary care and treatment, while providing quicker and more specific advice to primary care to support patients who do not need that secondary care.
Management within primary care might include reassurance for patients with lesions, guidance to monitor the condition, or medical treatment. I note that prescribing decisions are matters for clinicians, taking into account the individual circumstances and treatment needs of each patient.
Grass-roots Sport (Support)
To ask the Scottish Government what steps it is taking to support grass-roots sport in Scotland. (S6O-02402)
Earlier this month, sportscotland announced record annual investment figures to support the delivery of sport and physical activity. Across 2023-24, sportscotland will invest up to £36.7 million of Scottish Government and national lottery funding into Scottish governing bodies of sports, local authorities and wider national partners. That includes significant investment in support for grass-roots sport in Scotland, supporting local authority partners in the delivery of community and school sport through community sport hubs and the active schools network.
Since April 2007, sportscotland has invested more than £204 million to help sports clubs, community groups, local authorities, sports governing bodies and other organisations to deliver new and upgraded sporting facilities.
The minister will be aware that councils have been forced to close facilities due to Scottish National Party cuts. I am sure that she is also aware that the United Kingdom Government has invested in facilities across Scotland—including £500,000 in Lanarkshire—through its multisport grass-roots facilities programme. Does the Scottish Government have a similar specific fund for grass-roots sport?
We have discussed the issue of investment in grass-roots sports a number of times in the chamber. As I have set out, sportscotland is the body that we use to make those investments, and there has been a substantial increase this year in the investments that we are making in that regard.
In terms of local government finance, we absolutely recognise the crucial role that councils and their employees play in communities across Scotland, and the challenging financial circumstances that they face. However, under the UK Government, we have suffered a decade of austerity, with average real-terms cuts of more than 5 per cent, which equates to a loss of £18 billion. Despite that, local authority revenue funding is £2.2 billion—22.9 per cent—higher in cash terms in the current financial year than it was in 2013-14. That shows that we have managed to protect local authority budgets.
Of course, local authorities are democratically elected bodies and they make their own decisions about how they spend their money and where they focus their attention. As anyone would expect, central Government cannot interfere in those decisions.
A couple of members want to ask supplementary questions. They will need to be brief, as will the responses.
The minister mentioned active schools. Can she provide an update on the work that is being done with sportscotland to ensure that active schools programmes are free for all children and young people by the end of this parliamentary session?
We are working with sportscotland and local authorities to phase out charging for active schools, which is a really important commitment of this Government. Sportscotland continues to work with partners to address the very small number of cases where charging remains, and is taking a managed approach in order to avoid unintended negative impacts on the level of sport and physical activity provision in those communities.
Sportscotland’s record annual investment in local authorities—which reached £16.2 million last year—will support councils with rising staff costs and allow them to drive and strengthen the active schools programme’s focus on inclusion. That focus is about supporting children who are living in poverty, those with additional support needs and care-experienced young people to participate.
School provided many of us with our introduction to sport. Can the minister tell us more about investment in school sport and enabling the school estate to remain open after 4 o’clock, because sport is now becoming the bastion of the middle classes?
Brian Whittle and I have engaged on this issue many times. I recognise that we share a passion for sport. I argue that sport is not becoming a bastion of the middle classes, but has long been a bastion of the middle classes. In fact, our data illustrates that, other than participation in football, which is equitable across socioeconomic groups, almost all other sports favour the rich and wealthy. It has long been thus, which is why this Government is focused on tackling that inequality. We are focused on the active schools programme and on removing charging for it to ensure that every child who lives in Scotland can have the opportunity to participate in sport and gain the benefits that that brings them. Those benefits include not only benefits that would be associated with physical activity; as Brian Whittle can testify, involvement in sport brings other lifelong benefits.
Community Link Practitioners (General Practice)
To ask the Scottish Government what plans it has for the future of community link practitioners working with general practitioner practices, in particular in more deprived areas. (S6O-02403)
We remain committed to community link workers in general practice. Their role aligns strongly with the missions on equality and community in our policy prospectus, “Equality, opportunity, community: New leadership—A fresh start”, in which we also committed to increasing investment in general practice serving disadvantaged areas.
Funding for primary care improvement plans has been maintained at £170 million in the current financial year, and each health and social care partnership determines how to deliver link worker services within its own improvement plan. The Scottish Government recognises that there are service variations across Scotland, and we are currently reviewing local community link worker delivery in order to understand the benefits and challenges of those different approaches.
I take the cabinet secretary’s point that the HSCPs are central to how that delivery goes forward. However, would he agree that those link workers are very much valued by GP practices, especially in deep-end areas in constituencies such as mine? Would he agree that, if the GP practices and everybody else had a bit more certainty over funding for the future, that would help the patients, the GP practices and the staff?
Yes—I agree with the points that Mr Mason raises, including on the specific issues regarding his constituency. I appreciate that there has been a level of uncertainty for those staff and for the patients who have benefited from the community link worker programme. I am pleased that we have been able to address that uncertainty, as the member referred to, and I recognise that the health and social care partnerships are working to try to address some of the contractual issues as we move forward.
In addition, I reassure the member that, as part of the review programme that we are taking forward, I want to look at how we can give a greater level of certainty and consistency into the future with regard to how community link workers will be provided in general practices, particularly in our more deprived areas, in order to ensure that we are dealing with the issues in a consistent way that gives people assurance about our long-term vision in taking the programme forward.
A number of members have supplementary questions. They will need to be brief, as will the responses.
I agree that we need more community link workers. I absolutely value them when I get to work with them in practice. However, the Scottish National Party has broken its promise to GPs with the new contract. The £65 million cut has broken the SNP promise to all primary care, and the GP contract was and is detrimental to rural areas. I therefore ask the cabinet secretary why primary care and GPs should believe him now.
We have a very strong commitment to primary care. One of the examples of our commitment to improving and investing in it has been the rapid expansion of the multidisciplinary team across primary care. More than 3,000 additional staff, including allied health professionals, were brought into that particular group in order to expand capacity in our primary care setting by supporting GPs in their work alongside the very important work that our community link workers carry out. That is a clear example of this Government’s determination to expand and develop our primary care setting.
Community link workers play a crucial role in community mental health support in particular. The SNP’s previous programme for government, “A Fairer, Greener Scotland: Programme for Government 2021-22”, committed to establishing 1,000 additional mental health roles to support wellbeing hubs for every GP practice and improve community mental health resilience. Given that the summer recess begins next week, will the Scottish Government have created those roles before the next programme for government or will that be yet another failed commitment from this Government?
We are determined to do everything that we can to help to support the issues around mental health and the services that can help to support individuals who are experiencing mental health challenges. However, we have also had to look at prioritisation in our budget, given the budget cuts that we are experiencing as a result of decisions that have been made by the United Kingdom Government, which have a direct impact on the Scottish Government’s budget.
I assure the member that we will continue to look at what further support we can provide to GP practices in the way of community mental health support in order to ensure that we provide the support and assistance that is required.
The cabinet secretary’s presentation of the situation is not what people are facing in our communities. They are waiting a long time to get through to a GP because the recruitment has failed completely. The number of GP whole-time equivalents has dropped, 23 practices have closed in the past three years, and the multidisciplinary recruitment that he talked about has fallen well short of the targets.
I support link workers, but why does the cabinet secretary not get real and understand that people are really suffering in trying to access GPs?
Community link workers are an important part of the primary care team, but I suspect that the member has chosen to ignore the more than 3,000 additional staff that we have recruited into primary care over the past couple of years in order to expand and help to support capacity in that sector.
Notwithstanding that, however, I recognise that there are challenges. As a constituency MSP, I am very aware of the challenges that some of our constituents face, which is why we are also looking to increase recruitment within general practice. We need to consider how we configure primary care, ensuring that we refer people to the right services in the right way. That involves looking at the whole multidisciplinary team—GPs and the wider AHP team—so that they can support patients with long-term conditions, and even short-term conditions. That is exactly what the Government is determined to do, and that is the approach that we are taking going forward.
Ferry Cancellation Impacts (Highlands and Islands)
To ask the Scottish Government what discussions it has had with national health service boards in the Highlands and Islands region regarding whether there has been any impact on the delivery of their services as a result of recent ferry cancellations. (S6O-02404)
Scottish Government officials regularly meet representatives of all NHS boards, including those that cover the Highlands and Islands, to discuss any challenges that are impacting on activity and to provide any necessary support. We have not been made aware of any specific impact on the northern isles. However, I understand that some out-patient activity was postponed in the Western Isles, where the travel of visiting consultants was disrupted. The patients affected were reappointed at the next available opportunity.
Contingencies are in place for patients. For example, CalMac Ferries has a medical protocol, which guarantees islanders a booking on the ferry and a taxi should they have to attend an urgent medical appointment on the mainland. NorthLink Ferries will provide assistance to any northern isles residents who have issues in travelling to the mainland for medical appointments.
In addition to the problems that the cabinet secretary has mentioned, The Oban Times recently reported that the hospital on Islay was unable to book patients on to ferries this month due to reduced deck space, and the Scottish Ambulance Service has confirmed to me that the recent Corran ferry breakdown resulted in longer travel times for patients and delays in getting cover back to the area. What additional help can be provided to health boards to ensure that patients can access vital health services in the event of problems with the ferry network?
I recognise that some challenges have been experienced by patients who require to make use of ferries for the purposes of accessing services or coming on to the mainland for services. We would, of course, expect boards to consider putting alternative arrangements in place where it is feasible to do so, but the critical aspect is to get greater consistency and reliability within our ferry network in order to address the issues.
The member will be well aware of the actions that are being taken in order to address those issues. We expect boards to ensure that alternative arrangements are put in place when necessary and that, if appointments have to be rearranged, they are rearranged at as early a point as possible for patients.
Nursing and Midwifery Staff
To ask the Scottish Government how many nursing and midwifery staff have left the national health service in the last 12 months. (S6O-02405)
A total of 8,831 nursing and midwifery staff have left the NHS in the past 12 months. That information can be found on Turas in the information on the Scottish Government’s workforce planning programme.
I thank the cabinet secretary for that answer. New statistics have revealed that the use of agency staff increased dramatically in that period, rising to the equivalent of 1,741 whole-time equivalent nursing and midwifery staff in 2022-23. That is an increase of 1,018, or more than 70 per cent, on 2021-22. We know that nurses and midwives continue to leave the profession in droves due to stress and burn-out, and we know that, even though there is an astronomical use of agency staff, people cannot even access them, and wards are being left in perilous positions.
The cabinet secretary has not been in post for all that long, but he must accept that those are clear failures in workforce planning and he must take responsibility for addressing the issue. When is he going to prioritise the work of the new nursing and midwifery task force in order to ensure that it delivers a plan for providing the nursing workforce that Scotland needs?
Let me deal first with the use of agency staff and the member’s call for us to take action to address those issues. I am not sure whether he is aware of this, but action has already been taken. New protocols were introduced at the beginning of this month that place restrictions on health boards in order to reduce the amount of agency resources that they are using and to switch more towards using bank staff. Action has been taken on that, with restrictions being applied to health boards. I hope that the member will find that new information helpful to him.
On the point about prioritising the work of the task force, I am a little surprised by the tone of the member’s question. The task force has already met. I chair it, and we are due to have a second meeting. The work of the task force is already progressing. I will work with all the partners on the task force to ensure that we address the issues that it has been set up to address, including the examining of further pathways into the profession. No doubt, the member will welcome the work that the task force has carried out to date.
An analysis by the Nuffield Foundation, among others, makes it clear that Brexit is a key factor in the NHS’s staffing crisis. This week marks seven years since Scotland voted overwhelmingly to remain in the European Union, yet we continue to feel the full force of the Tories’ hard Brexit deal, which Labour fully supports. Can the cabinet secretary provide an update on efforts to ensure the further recruitment of midwives and allied health professionals from overseas in the face of those pressures?
Please answer as briefly as possible, cabinet secretary.
Brexit is undoubtedly having a significant impact on recruitment in a range of sectors—not just in Scotland, but across the United Kingdom—including in the health and social care setting. That is the reality and those are the facts on the ground. We now have to address that challenge despite the fact that the people of Scotland voted by a significant majority against leaving the EU.
We have been taking action to help to increase our recruitment from overseas. Recently, we were able to exceed our target of recruiting an extra 750 nurses and AHPs from overseas by making some 800 offers to staff. We will continue to take work forward with our health boards to consider how we can further increase recruitment in the years ahead.
Some fearsome new facts from the ground show that, for the first time, the number of staff who are leaving the health service has outstripped the number who are joining it, with 75,000 NHS staff being absent due to mental illness over the past five years. It is little surprise that record numbers of NHS staff are leaving the health service. Recruiting more NHS staff will have little effect if existing staff are leaving at a higher rate, so what steps is the cabinet secretary taking to ensure that our NHS staff are valued, respected and protected? Does he accept that his predecessor, Humza Yousaf, bears the responsibility for that exodus?
We have taken forward a range of work in order to continue to recruit into our NHS. I am sure that the member recognises the very significant challenges that Brexit is now posing for the recruitment of staff, as I mentioned. Our work includes—[Interruption.]
Does the member want to hear what I have to say or is she just going to shout at me from a sedentary position?
Paul O’Kane mentioned the nursing and midwifery task force, which is looking specifically at new routes into the healthcare professions and particularly into nursing through apprenticeships and earn-as-you-learn programmes, both of which can open up opportunities.
I gently point out to the member that we have more NHS staff in our NHS since the Government has come into office and that, in Scotland, we have more NHS staff per head of population than the Tories have in England. That demonstrates our commitment to investing in our staff, which we will continue, despite the very poor record that her party in England has on that matter.
Gender Identity Services for Children and Young People
To ask the Scottish Government what action it and NHS Scotland are taking to implement the recommendations of the Cass review into gender identity services for children and young people, as they apply to Scotland. (S6O-02406)
The NHS England-commissioned Cass review extends only to clinical services offered by NHS England. It is not considering or reviewing services provided by NHS Scotland. As members will know, how the national health service is structured and how services are commissioned differ in England and Scotland. However, as we continue to state, the on-going findings of that review, alongside other national and international evidence in the field, are being closely considered in the context of how such healthcare can best be delivered here as we work collectively to improve service delivery to children, young people and their families. Various workstreams are under way to deliver that.
To date, officials and senior clinicians from both the Scottish Government and NHS Scotland have met Dr Cass twice to share information on improvement work in Scotland, expected outputs of that review, associated timelines and opportunities for shared learning.
As the minister will know, the Cass review has highlighted the significant uncertainty surrounding the use of hormone treatments for children and adolescents with gender dysphoria, reflecting the views and concerns of many in the medical profession. On 9 June, NHS England announced that puberty blockers would not be commissioned for children and young people in those categories except as part of clinical research. In light of the very serious concerns that have been highlighted, will the NHS in Scotland now take that step, too? If so, when? If not, why not?
Decisions on prescribing that type of treatment are for clinicians to make in consultation with the patient, following individualised assessment, and they are subject to regular monitoring. The Scottish Government remains proactive in its commitment to help to deliver high-quality healthcare to children and young people in that sensitive field of medicine.
Consistent with that, preliminary discussions are taking place between Scottish Government and NHS England officials as to what form of engagement may be possible and appropriate with NHS England’s recently announced but not-yet-in-place clinical research study on puberty blockers. However, the situation in Scotland remains unchanged.
Significant Adverse Event Reviews
To ask the Scottish Government what analysis it has undertaken of the results from NHS Scotland significant adverse event reviews. (S6O-02407)
The national adverse events notification scheme has been in place since 1 January 2020, following the then Cabinet Secretary for Health and Sport’s instruction to Healthcare Improvement Scotland to collect significant adverse event review data for category 1 adverse events from health boards.
Health boards are responsible for delivering safe, effective and person-centred care at a local level. That includes inputting into the national notification system. The Scottish Government does not routinely request that data from Healthcare Improvement Scotland, but we work closely with it to ensure that the processes are implemented and improved in line with national policies and frameworks.
According to NHS Greater Glasgow and Clyde’s publication of 2020-21, the most common contributory factor to be identified in a SAER was guidance not being followed. Last year, my constituent Kathanna McGivern, who is in the public gallery, sadly lost her grandfather, John, when he was receiving NHS care. The SAER that was carried out confirmed that guidance had not been followed, which may have caused or contributed to his death.
How can the Government and NHS Scotland effectively learn from adverse events in order to improve the guidance that is provided and allow best practice to be actively promoted across Scotland?
I am sorry to hear of the loss Ms McGivern’s grandfather, John. I believe that she has written to me separately on the matter.
Safety is at the heart of everything that we do. The national adverse events framework has been developed by Healthcare Improvement Scotland in collaboration with NHS boards and its purpose is to provide an overarching framework. It has been developed using best practice to support care providers to effectively manage adverse events when they occur.
I assure Kaukab Stewart that Healthcare Improvement Scotland is currently reviewing the framework. We are considering what further work can be taken forward to ensure that we continue to learn from significant adverse events. We are taking forward a piece of work around what is called the community of practice, which is being trialled with NHS boards as part of the adverse events framework to ensure that we maximise the learning that can come from such incidents.
That concludes portfolio questions. There will be a brief pause before we move on to the next item of business.
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