NHS Scotland (Cyberattack)
To ask the Scottish Government whether it will provide an update on the cyberattack on 4 August 2022 which reportedly targeted NHS Scotland’s patient management software. (S6T-01010)
On 4 August 2022, we were alerted by NHS National Services Scotland that Advanced, a service provider for health and social care across the United Kingdom, had experienced a cyberattack. The UK-wide incident was contained by the supplier within a few days, supported by the National Cyber Security Centre. Regular public updates on the cyber incident and subsequent recovery were reported by the supplier, Advanced, covering all the systems that were impacted. The Scottish Government commented publicly at the time.
The target for the cyberattack was Advanced, not NHS Scotland health boards. The Adastra system used by out-of-hours general practitioners in Scotland, which was the main system impacted up here, was brought back online in October. I make it clear that no NHS Scotland patient data was affected and well-established contingency arrangements were in place to sustain effective delivery.
All Advanced systems have been tested and security checked, with close working by NSS with the National Cyber Security Centre and the Information Commissioner’s Office. I extend my sincere thanks to everyone who has been involved in responding to the incident so swiftly.
Following the attack, NHS staff were forced to keep patient records on paper, in emails and in Word documents. There are serious implications for patients’ safety, privacy and trust. Can the cabinet secretary confirm the scale of the data breach, including the number of patient records that were affected by the attack, and say what measures were put in place to keep patient data safe as digital systems were restored?
Let me just confirm what I said in my response a moment ago: no NHS Scotland patient data was affected. Also, importantly—this is a really important point, which Tess White has rightly raised—contingency was absolutely put in place.
First, core systems were fully restored and on-going monitoring by Scottish Government officials was very much in place. I should say that we were working on a four-nations basis, as it was an attack that affected every part of the United Kingdom. Local arrangements were also put in place to ensure resilience, and the contingency arrangements that were used had been in place for many years. They are well understood by both NHS 24 and the service. Contingency arrangements included updates to in-hours GP records, in line with standard processes.
Therefore, the attack took place, the contingencies that had been well rehearsed and well known about were put in place and I am pleased that, as I say, no NHS Scotland patient data has been affected.
The alarming reality is that, with on-going geopolitical turbulence, we are seeing more and more such malicious attacks and healthcare is clearly in the perpetrators’ crosshairs. How confident is the cabinet secretary in the resilience of health boards to defend against future attacks and does he agree with the former digital director of NHS National Services Scotland that the NHS needs to up its game in the face of serious cyberattacks?
Again, I thank Tess White for raising what is an exceptionally important question. She is absolutely right to say that there are improvements to be made. Right across the board, and particularly across the Scottish Government and the public sector, we are committed to ensuring that those improvements around cybersecurity happen, for all the reasons that Tess White rightly raises, in relation to state actors as well as non-state actors.
I give Tess White some reassurance around the fact that we work exceptionally closely with the National Cyber Security Centre. It, of course, advises right across the UK in relation to cybersecurity, and we have a contingency in place to deal with any attacks that take place. There is on-going work. We work individually with health boards and—again, I will be quite frank and honest with Tess White in my response—there are some boards that need that further support from the Scottish Government, which we are providing.
It is shocking that this Parliament and, more importantly, the public might not have been aware of the scale and severity of the cyberattack, had it not been uncovered in detail by a freedom of information request from Scottish Labour. That raises significant questions over transparency. Even by the standards set by his Scottish National Party predecessors, the health secretary’s report card in that regard is shocking. In 2017, following the last major cyberattack on NHS systems in Scotland, the then health secretary Shona Robison came to the chamber, made a statement and pledged to launch an inquiry so that lessons could be learned. Will the cabinet secretary explain why he failed to come to Parliament and make such a statement and, furthermore, will he explain what impact this cyberattack has had on waiting times and figures in NHS Greater Glasgow and Clyde?
As far as I am aware, it has had no impact, but I am happy to look into that and come back to Paul O’Kane with further detail.
The cyberattack was reported, in August, by STV News, BBC News, The Guardian and “The Nine”—a political programme on which I am sure that Paul O’Kane has appeared on numerous occasions. Further, the Scottish Government commented publicly at the time. I will double-check my records, but, in the four months since the report and the very public extensive coverage of the cyberattack in August, I do not think that I have had a single parliamentary question, a single piece of written correspondence or a single request for an urgent statement about the cyberattack from Paul O’Kane. If I have—I stand to be corrected—I will of course correct the record.
Cancer Inequalities
To ask the Scottish Government what steps it is taking to tackle cancer inequalities. (S6T-01004)
I thank Katy Clark for her important question. We continue to tackle cancer inequalities by ensuring equitable access to cancer services via our national cancer plan, which is backed by £114.5 million. We know that the earlier cancer is diagnosed, the easier it is to treat and even cure. That is why we continue to invest heavily in our detect cancer early programme, which also rightly focuses on closing the inequality gaps that Katy Clark has asked about.
To continue to minimise inequalities, we are currently developing a new 10-year cancer strategy and earlier diagnosis vision, which will launch in spring 2023. It will take a comprehensive approach to improving the patient pathway for all, with a focus on reducing and, indeed, eliminating those health inequalities that exist.
This week, Cancer Research UK reported that, each year, around 4,900 extra cancer cases are linked to deprivation in Scotland. What proposals will the Scottish Government lay out in its upcoming cancer strategy that specifically address that challenge?
I met Cancer Research UK yesterday, when I spoke at the Scottish cancer conference. I am grateful to the cross-party group on cancer, which was involved in the organisation of the conference, and to Miles Briggs, who hosted it.
I met representatives of CRUK after the conference to talk through the organisation’s report. A number of interesting points were made but, ultimately, the message from CRUK to the Scottish Government was very clear: it expects the new cancer strategy to have a laser-like focus on reducing the inequalities that exist.
I will not pre-empt the cancer plan. We have had many responses to the consultation, and I am grateful to all the individuals and organisations that have responded. I am looking to launch the cancer strategy early in the new year. If Katy Clark would like to have a conversation about the cancer strategy, my door is open to that. I give her an absolute assurance that reducing the cancer inequalities gap that exists is certainly a high priority for us.
I would be grateful to take the cabinet secretary up on his offer. As he knows, academics and public health experts argue that it is impossible to tackle health inequalities without addressing wealth and income disparity. Public Health Scotland argues that a reasonable income, sufficient welfare provision and what it calls an active labour market policy are essential for healthy living.
Will the Scottish Government be willing to carry out research to analyse whether those policies are being enacted, or whether an attempt is being made to enact them, particularly in deprived communities?
I will certainly consider the research proposal that Katy Clark has asked us to look into. I suspect that there is no difference between her and me in relation to her premise, which is that wealth inequalities undoubtedly lead to poorer health outcomes. That is why the work that we are doing across portfolios in Government on, for example, the whole family wellbeing fund is so important.
Katy Clark will know about our rapid cancer diagnostic services—we have just announced the roll-out of a further two. We can see from the interim evaluation of the first three RCDSs that they have had a significant impact in areas of deprivation. I can send her a further breakdown of that interim evaluation, which shows that such interventions allow us to target and focus on those areas of deprivation, which will result in better outcomes for all.
Cancer Research UK’s report echoes evidence that the Health, Social Care and Sport Committee heard during its inquiry into health inequalities, which showed that socioeconomic inequalities drive poorer health, as we have just heard.
Does the cabinet secretary share my concern that, in the midst of a cost of living crisis that was exacerbated by Truss’s disastrous mini-budget in September, the Chancellor of the Exchequer’s decision not to follow the lead of the Scottish National Party Scottish Government and match progressive policies such as the Scottish child payment, but instead to cut household incomes, will have a direct impact on the health of many low-income households?
There can be no doubt about that. I think that even Conservative members would acknowledge that the United Kingdom Government’s recent actions have exacerbated existing wealth inequalities.
As I said in my response to Katy Clark, the Scottish Government will do what we can, but the UK Government holds the vast majority of fiscal levers. If wealth inequalities are not addressed, that leads to poorer health for all. I have clearly said that, in my estimation, the cost crisis is also a public health crisis. The Scottish Government will do what we can to reduce the existing equality gap. In the meantime, I appeal to all in this chamber, including Conservative members, to use whatever influence they might have to get the UK Government to change course and to ensure that it is not making the cost of living crisis even worse for those who are already suffering in communities across Scotland.
The health inequalities that Katy Clark rightly identifies across all cancer diagnoses and cancer types are manifest directly because of income inequality. There is one type of cancer on which we manifestly have more to do, and on which it is in our power to do more, and that is bowel cancer.
I learned only today that we never really talk about bowel cancer in the chamber because we are meeting the target for the return of home test kits to the health service. That is because that target is set at only 60 per cent. That screening programme sends test kits to every adult of a certain age in our population, but we set the bar very low.
Will the health secretary’s Government consider increasing the target for the return of home test kits, so that we might catch more people, particularly in income-deprived backgrounds?
Alex Cole-Hamilton asks a good question and makes a reasonable point for me to consider. I will take that away. That issue is part of our consideration of screening. Our bowel screening programme has been incredibly successful and effective, but I take his point about being more ambitious with that programme. I will take that away and will get back to the member about it.
There are significant inequalities in access to screening. For breast and bowel screening, the uptake is 20 per cent lower in the most deprived populations than it is in the least deprived. For some, particularly people in rural areas, the cost of travelling to appointments will be unaffordable. Patients can apply to the NHS low income scheme for assistance, but given the cost of living crisis, could the cabinet secretary review whether those payments are sufficient and are having the desired effect? Will he look at what other solutions and support could be offered at local level?
Gillian Mackay is absolutely right: screening is one of the key areas in which we see inequalities. That is why I am very keen that we use our mobile screening units to ensure that we get into areas of higher deprivation.
On top of that, through the national cancer plan, we have allocated £2 million over 2021-22 and 2022-23 to tackling inequalities in the cancer screening programme. That fund provided £5 million to a number of projects over the previous five years. The specific aim was to tackle inequality in access to breast, bowel and cervical screening across Scotland.
I will, of course, consider the issue that Gillian Mackay has put to me and what more we can do in that regard.
Illegal Puppy Trade
To ask the Scottish Government what steps are being taken to tackle the illegal trade in puppies, in light of the Scottish multi-agency strategic threat assessment report that the trade is funding serious organised crime. (S6T-01012)
The Scottish Government continues to work with a number of key stakeholder organisations and other Administrations through the puppy trade working group to disrupt the activities of those who are involved in the unlicensed puppy trade. We have also run several puppy campaigns over the past few years to highlight the cruelty of the trade, to raise public awareness and to provide advice on how to buy a puppy safely.
New animal licensing regulations were introduced in 2021 that cover the breeding and selling of dogs, and further regulation is planned using powers that are set out in the Animal Welfare (Kept Animals) Bill, which is progressing through the United Kingdom Parliament.
Serious organised crime affects us all, and we can all play a part in reducing the harm that it causes. Raising awareness of the nature of the threats that we face is one part of that response. The Scottish Government and its partners on the serious organised crime task force oversee work to reduce the harm that is caused by serious organised crime in Scotland, and they will continue to use every means at their disposal to disrupt serious organised crime.
I thank the cabinet secretary for that response. Illegally traded puppies generate about £30 million of revenue for serious organised criminal gangs in Scotland—fuelled, no doubt, by the huge rise in demand. It is estimated that one in four dogs that are purchased could be linked back to criminality and low-welfare breeding.
A number of prolific serious crime gangs are operating in Scotland right now, both breeding in Scotland and importing through the port of Stranraer. However, the Government’s serious organised crime strategy barely mentions illicit puppy trading. There are surely doubts about whether the strategy is robust enough, given the scale of the activity.
I ask the cabinet secretary for some statistics, because the law must be strong on this. How many crimes of this nature are reported to or investigated by the police each year? How many are then prosecuted by the Crown? Of those, how many cases successfully result in a criminal conviction?
On the last point that Jamie Greene raised, different crimes or elements of crimes can be recorded in different ways. I am happy to make sure that the answer that I give covers all the different ways in which the illicit puppy trade might be touched on, and I will provide that information to him in writing.
I challenge the point about how much is being done. The scale and significance of the trade was the driver behind the creation of the puppy trade working group, back in early 2018. That United Kingdom and Republic of Ireland group includes key animal welfare organisations; the Scottish Government; the Department for Environment, Food and Rural Affairs; HM Revenue and Customs; the Irish Revenue; and the Convention of Scottish Local Authorities. Jamie Greene rightly identifies that one of the ports of entry is Stranraer, which is why we also work collaboratively with the Irish Government.
The principal aim is to disrupt unlicensed, low-welfare puppy farming and the associated criminal activity, which is taken very seriously. Jamie Greene will be aware that much of what we could say in relation to the SMASTA and the serious crime strategy is not made public for reasons that he will understand, but I am happy to make sure that as much information as possible is provided to him to convince him that we are doing what we need to do.
Further action is proposed, not least in relation to the age at which puppies may be transported. The transportation of dogs that are late in their gestation period, which is often hard to determine, is also going to be addressed, perhaps by reducing the periods in which pregnant dogs can be transported. We are taking serious action, and I am happy to follow that answer up by writing to the member.
I would appreciate those statistics being provided in writing where they are available.
They say that a dog is for life and not just for Christmas, but the reality is that many of these dogs will barely live beyond Christmas. Many of them come with their own health issues, incurring huge vet bills and, sadly, dying young.
It is highly likely that, right now, online selling platforms are advertising illegally traded puppies. I will not name and shame them, because we do not hold parliamentary privilege in this place, but we know who they are and they know who they are. It is shameful that we are not doing enough to tackle them by vetting advertisements and sellers.
I plug the good work of the Scottish Society for Prevention of Cruelty to Animals and its say no to puppy dealers campaign, but I ask the minister to say specifically what the Scottish Government is doing to drive wider public awareness and inform the public of the risks and the dangers, but also the moral issues that are involved in buying dogs from dodgy dealers, given that its most recent campaign was over four years ago.
I have already mentioned that we carry those publicity campaigns, but there are a number of other ways in which we can raise awareness. Jamie Greene’s question was perhaps prompted by a press release that was issued by the Crown Office, which draws attention to these matters. They were also highlighted when the SMASTA was published.
We do those things, and we work with other organisations. The member rightly mentions the Scottish SPCA, with which we work very closely on the matter. However, we will always look to highlight it even more, not least at this time of year, when it can be the case that people want to buy a dog or a puppy for Christmas.
Just to find some common ground, both of us are agreed that the trade is abhorrent and that we should do all that we can to limit it, not least because the very transportation of those animals is detrimental to the health of some of them.
We will continue to work on the issue. As I have said, I will provide to Jamie Greene the information that I mentioned.
Further to that exchange, I advise the cabinet secretary that my proposed bill on the welfare of dogs is shortly to be presented to the Parliament. Its purpose is responsible dog ownership—in other words, the tackling of demand as a way of dealing with the supply of the illegal trade. I associate myself with the exchange with Jamie Greene. In so far as it is possible, I seek to stop online purchase from sites such as Gumtree. Although the cabinet secretary does not have the relevant portfolio responsibility, I ask whether he looks forward—as I do—to Scottish Government support for my bill.
I am not unaware of Christine Grahame’s member’s bill. On her first point, and to go back to the previous discussion, encouraging responsible ownership has to cover people’s being conscious of where they buy a puppy in the first place.
We welcome proposals that seek to improve animal welfare, including Christine Grahame’s proposed bill on the welfare of dogs. I thank her for sharing a recent draft. Officials are still considering the proposals, and I look forward—or rather, Mairi Gougeon, who is the appropriate cabinet secretary, looks forward—to discussing the bill in further detail once she has had the chance to fully consider it.
As we have heard, animal welfare is an important and emotive issue. I am sure that all members will welcome the opportunity to consider what more can be done to strengthen Scotland’s high animal welfare standards.
As we have heard, Cairnryan, in my constituency, has the unfortunate reputation of being the main gateway for puppy trafficking from the Republic of Ireland into the UK. Although the likes of Stena Line do a lot to detect the illegal trade, puppies are still getting into the country.
The Dogs Trust polled 2,000 puppy buyers and found that 30 per cent were willing to buy a puppy even if they thought that it had been illegally bred. Given that we are in the run-up to Christmas and that there will be a high demand for such puppies—which can go for as much as £3,000—what additional support can the Government give to the SSPCA and the police in my constituency to make sure that that trafficking does not go beyond the port? We hear of puppies being sold from the backs of vans on the A75 and the A77.
I have already mentioned the support of working in collaboration with the SSPCA. Police Scotland has an overall increase of £40 million in its budget for the current year; however, the operational methods by which it drives down the trade are, of course, a matter for Police Scotland.
I hope that Finlay Carson will take some comfort from the fact that the serious organised crime task force is looking at the issue. It involves 13 organisations, including the Society of Local Authority Chief Executives and Senior Managers, the National Crime Agency, COSLA and Police Scotland. Its refreshed strategy was published in February. Although the aims and objectives remain broadly the same, I go back to the first point that was made by Jamie Greene: as well as the trade’s being appalling in itself, its proceeds sometimes feed further illicit activity, in relation to drugs.
There is a very serious focus on the issue. It is not always possible to be explicit about the way in which we are trying to deal with it, because, obviously, we do not want to forearm those who are involved in the activity. However, Finlay Carson should be reassured that there is a joint approach that takes in the Irish Government as well as the UK Government and HM Revenue and Customs.
That concludes topical question time.