Good morning. The first item of business is general question time. In order to get in as many members as possible, short and succinct questions and responses would be appreciated.
Housing (Discussions with Fife Council)
To ask the Scottish Government when it last met with Fife Council housing officials and what was discussed. (S6O-03046)
The Scottish Government officials regularly engage with Fife Council housing officials. The last meeting took place on 15 November 2023, and focused on progress with this year’s affordable housing supply programme in Fife. I met the housing convener of Fife Council just yesterday, as part of a regular series of meetings.
I wish to raise a serious and urgent housing case, and I will be happy to share the details with the minister.
My constituent has been in a specialist rehabilitation unit for more than a year, following a catastrophic accident as a pedestrian. He is ready to be discharged, but there is simply no housing for him to go to. I implore the housing minister to use his good offices to raise the case with the head of housing at Fife Council, because we need to see some urgency on this case, so that my constituent’s young son and daughter can finally have their dad home, and so that we can free up a highly prized rehab space for someone who is in urgent need.
I thank Annabelle Ewing for raising the case. I am sorry to hear about her constituent’s accident. Of course, I share her concern. Although that is a matter for Fife Council, I will ask my officials to liaise with the local authority to try to secure the best possible outcome for her constituent and his family.
Medicine Shortages (Representations to United Kingdom Government)
To ask the Scottish Government what representations it has made to the UK Government regarding any medicine shortages in Scotland. (S6O-03047)
The Scottish Government meets routinely with the Department of Health and Social Care and the other devolved nations to discuss and consider mitigations against the impacts of medicine shortages. That is done primarily through the fortnightly United Kingdom medicines shortage response group meetings, which are attended by the chief pharmaceutical officer for Scotland. Medicine shortages are also discussed in other regular meetings with the UK Government, the pharmaceutical industry and the national health service.
Although we are working with partners to try to manage supply issues and to offer advice to healthcare professionals about suitable alternatives, the regulatory powers on the supply of medicines are reserved to the UK Government. NHS Scotland has a robust system in place to manage medicine shortages when they arise, and anyone who is affected by a shortage should speak to their clinical team in the first instance.
I have been contacted by constituents who are extremely worried about their difficulties in obtaining certain prescribed drugs, and how that is impacting on their physical and mental wellbeing. The latest figures indicate that 96 medicines were on the shortage list at the end of last year, which is double the amount in the previous two years. As the minister said, the matter is reserved to the UK Government. What, if anything, can the Scottish Government do to ensure adequate supplies?
I completely understand the frustrations and worries of patients that disruption in supply of their medicines might cause, and I thank Gordon MacDonald for raising the subject in the chamber. However, it is often the case that a suitable alternative can be prescribed. That is why it is important for people to speak to their clinical team.
Medicine shortages are not unique to Scotland—they have an impact in the whole UK. A number of factors contribute to medicine supplies issues, including Brexit and regulatory processes.
We continue to work with and to press the UK Government, the industry and health boards to find a lasting solution in order to minimise the impact on patients.
The number of prescriptions for adult attention deficit hyperactivity disorder medication has increased sevenfold over the past decade, and constituents have told me of waiting times of two years, in some cases, for a diagnosis. Can the minister provide an update on the ADHD medicine shortage in Scotland? How can the Scottish Government address the unmet need of those who cannot get the medication or diagnosis that they need, when they need it?
As I outlined in my last answer, we continue to press the UK Government, the industry and health boards. I have some dates with regard to ADHD issues, with which I am very happy to furnish Paul Sweeney.
The minister will recall, from our earlier correspondence, the difficulties that a constituent and general practitioner have raised in relation to Ozempic, which is a diabetes medication. I know that national patient safety alerts have been issued to health boards, reiterating that off-label use of such medicines for weight loss and management of obesity is strongly discouraged. Will the minister, either now or in writing to me, set out the changes that she is looking to take forward with the UK Government to expand regulatory controls over that medication?
I thank Liam McArthur for raising the issue in the chamber. It is a really important point to discuss. I will be happy to furnish him with the correct information once I get back to my office.
General Practitioners and Consultants (Recruitment and Retention) (Rural Areas)
To ask the Scottish Government what steps it is taking to improve recruitment and retention of GPs and consultants, particularly in rural areas. (S6O-03048)
Improving recruitment and retention of GPs and other doctors is vital to Scotland’s health in all localities, including rural areas. We provide a range of support to the GP workforce, including a rural-specific graduate entry medical degree, the Scottish graduate entry medicine programme—ScotGEM—golden hellos for harder-to-fill posts and bursaries for GP specialty training, which are all aimed at attracting GPs to work in rural Scotland.
The Scottish Government funds the national centre for remote and rural health and care, which focuses on recruitment and retention, education, training, research and evaluation, leadership and good practice. We will publish our remote and rural workforce recruitment strategy by the end of 2024.
Staff shortages mean that the public are waiting too long for in-person, face-to-face appointments. The number of GPs has not increased under the Scottish National Party—it has decreased. Practices in Ayrshire are closing due to a lack of GPs, and services at local hospitals are being downgraded due to a lack of consultants. That is unacceptable, and it is leaving patients, particularly in rural areas, without the care that they need. Will the cabinet secretary tell the people of Ayrshire what he is doing to reverse the decline?
I mentioned a range of measures that we are taking to support recruitment of GPs into rural areas. Alongside that, we are increasing the number of training places in general practice. I am sure that the member will be pleased to hear that, in the general practice specialty training programme this year, not only have we had an increase in places, but from the second quarter of the recruitment programme we are at 100 per cent for those who are looking to go into general practice. The combination of increased training places with the incentives that we have put in place to encourage doctors to work in our rural areas is part of the programme of work that we are undertaking to encourage more doctors to work in our rural communities.
The cabinet secretary will be aware of the recruitment challenges in the Highlands and Islands. A quarter of the general practices in the north Highlands are run by the national health service. The cost of living, including food prices, on islands is 20 per cent to 30 per cent higher than it is in the rest of Scotland. Therefore, services are being withdrawn then being provided by very expensive locums. The Scottish Government does not allow NHS boards to pay a premium that takes into account those costs, for fear of causing internal competition. What will the Scottish Government do to ensure that there is equal access to healthcare, regardless of where people live?
Of course that is important. If Rhoda Grant wants to write to me about the incentive that she is referring to, I will be more than happy to look at the matter.
I am not entirely clear about the point that Rhoda Grant was making, but I mentioned a range of measures that we are taking to support recruitment into general practice in our island communities, all of which play an important part in helping to address the member’s concerns. The establishment of the national centre for remote and rural health and care has a particular focus, in its early work, on primary care, and is looking particularly at issues and challenges in the Highlands and Islands of Scotland.
Hernia Operations (Waiting Times) (NHS Dumfries and Galloway)
To ask the Scottish Government when it last discussed waiting times for hernia operations with NHS Dumfries and Galloway. (S6O-03049)
The Scottish Government meets national health service boards on a regular basis. We also commission and work closely with the centre for sustainable delivery, which was set up to drive service improvement, innovation and redesign. It regularly meets health boards to discuss any challenges that impact on activity and to provide any necessary support. The centre for sustainable delivery last met NHS Dumfries and Galloway on 17 January this year.
The Scottish Government remains committed to reducing waiting times and improving access to services, including for general surgery. We are working closely with all NHS boards, including NHS Dumfries and Galloway, where targeted work is being taken forward with weekend working focused on hernia repair and laparoscopic cholecystectomies, to make sure that we continue to develop programmes for dealing with issues related to hernia repairs.
I have a constituent in Dumfries and Galloway who, having been diagnosed with a double hernia, has been waiting for treatment for four years. Another person’s hernia operation in August 2022 was cancelled 10 minutes before they were due to go into theatre. Because of cancellations, they are still waiting. Another person inquired two months ago about how long they would need to wait and was told by the local hospital that it had no idea and was still looking at referrals from last June. I could go on.
Waiting lists for hernia operations in my region have risen by 175 per cent in the past five years, and a year is now the median wait. Does the cabinet secretary think that that is acceptable? If not, will he tell my constituents when he will bring down those waiting times? Frankly, they are waiting far too long.
I recognise that individuals are waiting too long, but Colin Smyth will recognise that, in the past five years, there has been a global pandemic that has had an impact on planned treatment.
As I mentioned, NHS Dumfries and Galloway is taking forward work to provide targeted support and to address delays to hernia repairs. That is, along with the work that the health board is doing on gallbladder operations, intended to reduce the waits that the member referred to. We will make sure that health boards will, as they produce their detailed plans for 2024-25, continue to take measures to reduce those long waits.
Let us ensure that we are concise, colleagues. We will get more members in.
Adult Neurodevelopmental Pathways
To ask the Scottish Government what progress has been made, including through any funding to the national autism implementation team, to help all national health service board areas establish adult neurodevelopmental pathways. (S6O-03050)
Excellent progress has been made in many board areas since we accepted the recommendations of the “Adult Neurodevelopmental Pathways” report last year. We have provided £567,000 for implementation to the national autism implementation team. Nine of the 14 NHS health boards in Scotland now have adult neurodevelopmental pathway strategic groups, and five have a current local action plan. Progress in that area remains a priority.
I am pleased to hear about the progress thus far. However, there remain gaps for adults who present with symptoms of attention deficit hyperactivity disorder or other neurodevelopmental conditions while they wait for the establishment of adult pathways. What further help is available at that intervening point until we reach the 100 per cent coverage that the minister clearly seeks?
I absolutely appreciate how difficult it can be to wait for a diagnosis and that the picture is inconsistent across Scotland. That is why we are continuing to fund the national autism implementation team, which works with and supports boards. That work includes establishing and reviewing evidence on best practice, forming strategic groups and responding to specific issues in local areas.
We launched the adult autism support fund last year. In the first six months of the fund, we distributed £500,000 to charities that directly support individuals with a diagnosis and, crucially, those without a formal diagnosis, so that those who are awaiting diagnosis can access support.
Gambling (Tackling Harm)
To ask the Scottish Government what action it is taking to tackle the potential harm of gambling to individuals, families and communities. (S6O-03051)
People with a gambling addiction in Scotland can get support, as appropriate, through a range of services, including those signposted on NHS Inform, primary care services, mental health services and secondary care. We have established a gambling-related harms working group with Public Health Scotland to consider what needs to be prioritised for gambling harms research, prevention and treatment.
The United Kingdom Government white paper, “High stakes: gambling reform for the digital age”, includes proposals on a levy to fund research, prevention and treatment. The Scottish Government continues to engage with the UK Government to ensure that Scotland benefits from those proposals.
Covid has exacerbated the harms from gambling, with more women now reporting that they have a gambling problem. The Greater Manchester Combined Authority has published the “Gambling Harms Action Plan” to try to alleviate the blight on lives that problem gambling creates. Will the Government consider creating a similar gambling harms action plan to help to protect the people of Scotland?
I will reflect strongly on Kevin Stewart’s points about the increase in the number of women gambling. Our gambling harms working group will be considering our local authorities’ action plans, as well as the approaches that are taken in places such as Manchester.
I recently met representatives of Glasgow City Council, which hosted a gambling harms summit in 2021 to share knowledge, insights and ideas on tackling gambling harms. From that, it has produced an action plan that takes a whole-system approach to tackling gambling harms.
As I said, we will continue to work with the UK Government on measures in its white paper on gambling reform.
Net Zero Fishing Vessels (Charges) (Engagement with United Kingdom Government)
To ask the Scottish Government what engagement it has had with the UK Government regarding any charges levied by the Maritime and Coastguard Agency for converting to, and investing in, net zero fishing vessels. (S6O-03052)
The Cabinet Secretary for Rural Affairs, Land Reform and Islands recently wrote to the United Kingdom minister who is responsible for maritime, international issues and security about the fees that are charged by the Maritime and Coastguard Agency in relation to modifications intended to transition fishing vessels to electric power. They confirmed that, for fishing vessels under 15m long, the fees that are payable relate to the actual costs that are incurred and are recovered in line with regulations.
Supporting and encouraging early adopters of electric technology on board fishing vessels is a key aim of the Scottish Government.
There is a pressing need for the fishing industry to decarbonise. Last year, a study that was produced for Fisheries Innovation & Sustainability warned that failing to invest in alternative technology could leave fleets unviable. Despite that, fishers who are looking to convert vessels from diesel to electricity face sizable fees from the Maritime and Coastguard Agency. Does the minister agree that the UK Government should be encouraging that kind of investment instead of raising unnecessary barriers?
Minister, please redirect your microphone a little before you begin.
Thank you, Presiding Officer.
As Kenneth Gibson rightly points out, our fishers are the most innovative in the world and are early adopters of technology. The Scottish Government has given £900,000 in support of fuel efficiencies and adaptation of fishing vessels.
It is disappointing that the UK Government and the MCA are creating barriers that could prevent small fishing businesses from benefiting from innovative technologies in emissions reduction and autonomy, which is why we wrote to Mairi Gougeon’s UK counterpart to raise concerns about that approach. Sadly, the UK Government does not seem inclined to act to help smaller vessels to mitigate and adapt to climate change. However, as always, we will continue to make that important case.
Woodland Planting (Annual Targets)
To ask the Scottish Government what percentage of annual woodland planting targets have been met in each year since 2017-18. (S6O-03053)
Since 2017, in the face of significant challenges including Brexit, Covid and weather disruption such as storm Arwen, Scotland has delivered, on average, about 75 per cent of the annual woodland creation target. Scotland’s contribution to all woodland planting across the United Kingdom over that period is more than that of any other UK nation.
Even before the Scottish National Party Government announced a £32 million cut to the forestry grant scheme, it had already failed to meet five out of its six annual targets. Mairi Gougeon has admitted that the SNP Government will fail to meet next year’s target. Is that massive budget cut a sign that the minister has completely given up on meeting net zero targets and woodland creation planting targets? [Interruption.]
Let us hear the member.
The funding support is important. However, despite the cut to our capital allocation by the UK Government, we will still create more than 9,000 hectares of new woodland. Woodland creation is a long-term activity, and we have significantly invested in the forestry sector in Scotland to increase its capacity to deliver woodland creation.
Although the reduction in grant funding is not what we wanted, other sources of funding for tree planting are increasing, and we remain committed to increasing woodland creation in the medium term, despite this year’s challenges.
Scotland outperforms the rest of the UK on tree planting, but further action is needed to ensure that barriers to progress do not prevent us from reaching our targets. Does the minister share my bemusement at the fact that, while the Tories want more money for various initiatives, they are content with Scotland’s budget being slashed, as their bosses in Westminster did not lift a finger to stop it?
Ms Harper makes a good point. A trend is emerging—[Interruption.]
Let us hear one another.
—with every decision that we have had to make as a result of a worst-case autumn statement and the capital allocation being cut, yet the Tories ask why we are cutting things in our budget.
The message is clear: farmers and crofters are better off with the Scottish Government than any Westminster Government, whether Labour or Tory. The Tories should not just take our word for it—they should listen to farmers in Lancashire and Wales, who fear for their very existence.
We are—
Thank you, minister.
Air adhart
First Minister’s Question Time