Good morning. The first item of business is general question time.
Question 1 has been withdrawn.
General Practitioner Surgeries (New Patients)
To ask the Scottish Government how many general practitioner surgeries are not currently accepting new patients. (S6O-02887)
The Scottish Government does not hold that information. However, I am clear that patients should always have access to general medical services. Practices must apply to their health board to close their list and agree the conditions and timeline for reopening them. Circumstances will arise in which a practice experiences capacity issues and is unable to routinely accept new patients on to its list. We expect health boards to work with practices as constructively and flexibly as is appropriate to help to manage the situation and ensure that all patients have access to GP services.
There can be no denying that, under the Scottish National Party Government, GP surgeries and our GPs are particularly overworked and overstretched. Statistics that were published this week show that, in the past 10 years, the whole-time equivalent number of GPs has plummeted by 200, but the number of registered patients in Scotland has soared by more than 390,000 in the same period. If the Scottish Government were a patient, would it accept that from its GPs?
I recognise that general practice services are under pressure and that they are under greater pressure in some parts of the country than they are in others because of population shifts, which create particular challenges for practices.
Martin Whitfield will be aware of the significant investment that we have put in to expand the primary care team, with some 4,700 additional staff being recruited to support our general practices throughout the country. That includes physiotherapists, phlebotomists and pharmacy services. All of that helps to support general practice. Alongside that, there is the commitment that we have made to recruit an extra 800 GPs over this parliamentary session and into the next parliamentary session. We are making good progress on that.
However, I recognise and acknowledge the challenges that general practices have. We have been expanding the primary care team around them to ensure that patients can receive a broad range of services within general practice.
GPs want to keep their lists open but, to do that, they risk becoming overwhelmed and they cannot offer the same level of service. A particular issue arises with the construction of new-build developments—the cabinet secretary has referred to that. Planning permission is often conditional on developers improving things such as local infrastructure, roads, rail and cycle paths, and investing in schools to cope with increases in the population of the area. However, no provision is made for increasing primary care capacity, and GP surgeries become inundated with new patients when they are already full to capacity. Will the Scottish Government look at addressing that issue?
I recognise that that has been a long-standing issue. It has even been experienced in my own constituency when there have been new housing developments. That can place pressure on local health infrastructure, particularly primary care services.
I am very open to looking at whether there is more that we can do to ensure that the potential impact of residential developments on local health infrastructure can be addressed more effectively through how planning arrangements operate in local authorities. I am more than happy to engage with Sandesh Gulhane on that issue to see whether further action could be taken.
The cabinet secretary seems very laid back about the issue. It is clear that he has not read the words of Dr Andrew Buist from the British Medical Association, who has said that demand is outstripping capacity, GPs are working beyond safe limits and they are exhausted and burnt out. The cabinet secretary acts as if this is not an emergency. What new steps will he take to deal with this emergency before patients suffer?
I am acutely aware of the challenges and the need for action to be taken on the matter. I think that I have met Andrew Buist three times in the past two weeks alone, and we have discussed those very issues. Therefore, I am acutely aware of the pressures on general practice.
We are taking measures to increase recruitment, and the level of specialist training provision for general practice is increasing. We have more people coming into general practice. I believe that, this year alone, we have been oversubscribed in respect of those who have wanted to go into general practice as a specialty. We continue to look at how we can increase numbers in the years ahead.
We want more GPs. We have, of course, more GPs in Scotland per head of population than there are in any other part of the United Kingdom. There is also the recruitment of the wider primary care team. Some 4,731 additional staff are being provided. That includes physiotherapists, phlebotomists and pharmacy staff, all of whom are critical in meeting the wider demand that patients have. They take away some of the direct demand from general practice and allow others to get the support that they require, whether that be through a physiotherapist—
Thank you, cabinet secretary.
—or a pharmacist. They all play an important part.
Death Certificates (Relationship Status)
To ask the Scottish Government what its position is on whether the current options available to record the relationship status of a deceased person are sufficient for the purposes of this information being accurately represented on death certificates. (S6O-02888)
The information that is recorded in an entry in the register of deaths is intended to form an accurate and permanent legal record. The high-quality records that are produced by registrars form important sources of historical information and allow people who are researching their family past to make clear and accurate links to their ancestors. The information that is required is set out in a Scottish statutory instrument that was made by the registrar general and approved by the Scottish ministers. The required relationship information is “Marital or civil partnership status”.
I apologise to the cabinet secretary for the complexity of this supplementary, but I ask her to bear with me. Only the wife, husband or relative of a recently deceased person has the legal right to register their death. Partners who are cohabitants, regardless of for how many years, do not have that right. They must either own property with the loved one who has died or be present at their death. Cohabiting partners are also not allowed to be recognised on the death certificate.
However, apparently some registry offices can record the deceased as being survived by their former partner whom they divorced many years ago. That is the key point. Does the Scottish Government consider that to be right in such cases or, in fact, accurate, if they have been long divorced? Could that happen where there has been an abusive spouse? I just raise that question. If the deceased’s status was divorced and they have a surviving partner, perhaps there is no need to record the former relationship. I wonder whether the Scottish Government could raise awareness—
Ms McNeill, we need to get to the question to the cabinet secretary, please.
—among cohabiting partners and awareness that registrars should be sensitive to such cases.
Cabinet secretary, I hope that you managed to get that.
This is indeed a somewhat complex matter. The Scottish Government has given some consideration to it, because we have had correspondence about it. We recognise that many couples today live together in enduring relationships and that that is becoming more common. However, there are some complications around allowing a cohabitee or cohabitant to be included in the entry on the death register. I am happy to write to Ms McNeill in detail, but one example of a complication would be if the registrar was faced with a situation in which the deceased remained legally married or in a civil partnership but was also cohabiting at the time of death: it would not be clear whether the person should be recorded as cohabiting or married.
On the issue of different practice, that would not be my understanding—
Cabinet secretary, you are over your time. You will need to write to the member.
I will follow up in correspondence.
Cladding Remediation Programme
To ask the Scottish Government whether it will provide an update on its cladding remediation programme. (S6O-02889)
The safety of home owners and residents is our absolute priority. That is why we introduced the Housing (Cladding Remediation) (Scotland) Bill on 1 November, which will give ministers new powers to ensure the remediation of buildings with unsafe cladding, and it is why we are seeking the transfer of powers in order to create a building safety levy. We are undertaking a robust programme of pilot single-building assessments. Those assessments are being completed and remediation work is under way.
At our recent Local Government, Housing and Planning Committee meeting, we heard that, of the 105 buildings in the pilot programme, only 27 have had assessments commissioned, only one building has had remediation work and only one building has had mitigation measures. Will the cabinet secretary explain that progress and give an assurance that the work will proceed at a much faster pace?
When the Minister for Housing gave evidence to the committee in May, he acknowledged that, for many home owners, the process has taken too long. The tenure system in Scotland is, of course, different from the system in England, and that complexity is an additional challenge for the programme, given that we do not have single building owners. Last year, the then cabinet secretary announced a change in approach to the programme, moving from a grant model to a direct procurement model, which has led to a real increase in the pace of the programme. I hope that that gives Mr Coffey some reassurance on the issue.
I understand from meetings with the minister and a round-table meeting that Kaukab Stewart held yesterday how challenging the issue is for the Government. I also know from my constituents and others that people whose buildings are affected appreciate communication from the Government. Can the cabinet secretary advise whether the Scottish Government will consider proactive communications on a regular basis with affected building owners in order to increase awareness of the process of remediation and the timescales for it?
The Minister for Housing has had conversations with a number of MSPs as well as, importantly, directly with residents in recent weeks and months since taking up his post. He is keen to ensure that we improve communication with the home owners of the buildings in the programme. Further to that, I understand that he has asked officials to scope several options, including regular communications on the overall programme flight path, as well as building-specific communications. I expect that to be implemented in the new year. I am sure that the minister will keep Mr Macpherson updated on progress.
As has been stated, in Scotland only one such programme of works has been progressed. A huge amount of detail is not in the Housing (Cladding Remediation) (Scotland) Bill, including on the single building assessment, the cladding assurance register and the responsible developers scheme. Does the cabinet secretary acknowledge that the continued absence of that detail in the bill creates risks for those who are affected, including residents and home builders, and that it has the potential to prolong uncertainty for residents who are impacted?
I am sure that the minister would be more than happy to go into the details of the issue with the member. However, I will give an example of the reasons behind our approach. Our approach for the responsible developers scheme aligns with the approach that has been taken by the United Kingdom Government when establishing its responsible actors scheme. The UK Government also put the details of that scheme in secondary legislation. The level of detail that is required for the scheme is more suited to secondary legislation, but I am sure that that is a discussion that the Local Government, Housing and Planning Committee will have when taking evidence on the bill, to which the minister will be happy to respond.
Care Homes (Rural Areas)
To ask the Scottish Government what action it is taking to ensure that rural populations have convenient and appropriate access to care homes. (S6O-02890)
Although we have overall responsibility for health and social care policy in Scotland, the statutory responsibility for delivering, commissioning and charging for services lies with local authorities and health and social care partnerships. We have set clear standards for the quality of care that is provided in Scotland, which includes convenient and appropriate access to care homes. My officials and I regularly engage with local partners to assure ourselves that those standards are met nationally. We are also committed to building a national care service to improve the quality and consistency of social care across Scotland, recognising that, often, a different approach is needed for people who live in rural communities.
South Lanarkshire Council is currently consulting on proposals to close the McClymont house care home in Lanark in order to fill a £20.8 million shortfall in its social care budget, which was compounded by the Government’s clawback of circa £18 million from the health and social care partnership earlier this year. The next nearest council-run facilities are located in the central belt towns of Hamilton, Rutherglen and East Kilbride. What is the Scottish Government doing to prevent the closure of care homes in rural areas, such as McClymont house care home in my constituency, that provide vital services to the community,?
As I said in my earlier answer, we set the standards and the policy direction for social care, but local authorities have responsibility for commissioning, delivering and charging for those services. As I said, we are working towards a national care service that I think will improve the situation in both rural and urban settings, but I have no locus to become involved in care home closures in local areas.
Question 6 comes from James Dornan, who is joining us remotely.
It is vital that high-quality adult social care—
Please stop, Mr Dornan. I had moved to question 6, which is allocated to you.
My apologies. I had a supplementary for question 5.
Yes, but I have not taken it, Mr Dornan. Please move to question 6.
I am now going on to question 6, Presiding Officer.
“Social security in an independent Scotland”
To ask the Scottish Government how the proposals outlined in its latest “Building a New Scotland” paper, “Social security in an independent Scotland”, would support Scotland’s social security system. (S6O-02891)
Our latest “Building a New Scotland” paper sets out how, with independence, we could build on the progress to create a fairer system that we have made with limited powers. The paper demonstrates how an independent Scotland could go even further by introducing early reforms to universal credit, scrapping the two-child limit and the rape clause, scrapping the young parent penalty and stopping the roll-out of changes to reserved ill health and disability benefits. In time, we could build a fairer system, such as one with a minimum income guarantee to ensure that everyone has an income to live a dignified life.
The “Building a New Scotland” paper outlines how future Governments in an independent Scotland might implement and build on a minimum income guarantee in a way that cannot be fully achieved within the limits of devolution. Will the cabinet secretary elaborate on that proposal and on the necessity of independence to achieve true financial security and wellbeing for Scottish households?
It is disappointing that, given that the Conservatives and Labour at United Kingdom level seem to still be refusing to change our welfare system, we will have to do what we can within the settlement that we have. We have made progress but, as the interim report from the minimum income guarantee expert group showed, there are limits to what can be done under devolution on a minimum income guarantee.
The group will produce its final report next year. I look forward to its recommendations on next steps that we can take under devolution and—importantly—on how the powers of independence may be required to allow our citizens to have a truly dignified social security system.
I do not want to state the obvious, but the paper is the latest iteration of what the Scottish National Party might do in a hypothetical future and it does nothing to support Scotland’s social security system now. That system has overspent massively on information technology, has waiting times for processing claims for adult disability payment and other benefits that are through the roof and has delayed the transfer of key benefits, which has left them in the hands of the Department for Work and Pensions. Should not the Scottish Government focus on running a properly functioning system now, rather than on dealing in hypotheticals?
I will give one example of how we have used our powers already, which is through the Scottish child payment. We created that because universal credit is inadequate. What a shame it is that we will have to continue to mitigate the worst excesses of any UK Government—whether it is the Tories or Labour—because of both parties’ absolute refusal to take seriously the impact that welfare reform has had on our citizens. Is it not a shame that Mr O’Kane’s party seems quite happy to back the Tories in keeping people in poverty, rather than lifting them out, as we do through our social security system?
Ambulance Waiting Times (North-east Scotland)
To ask the Scottish Government what action it is taking to reduce waiting times for ambulances in north-east Scotland. (S6O-02892)
The Scottish Government continues to work closely with the Scottish Ambulance Service and NHS Grampian to improve hospital handover times for ambulance crews at Aberdeen royal infirmary and Dr Gray’s hospital in Elgin, which is having a significant impact on response times. NHS Grampian has identified that it requires additional acute capacity to meet demand and it is in the process of opening 40 new acute beds to ease capacity pressures. Eighteen of those beds are operational and a further 14 are expected to open by mid-January. That is expected to improve patient flow through ARI and reduce ambulance stacking.
Long wait times for ambulances seem to be caused by ambulances being queued up at Aberdeen royal infirmary for hours on end. Earlier this year, my father had a six-hour wait in severe pain in the back of an ambulance; such waits now seem to be commonplace. Ambulance drivers and paramedics are doing a brilliant job, but they are being failed by the devolved Government. Will the cabinet secretary work with NHS Grampian to improve the situation and stop those excessive waits?
I am sorry to hear about the difficulty that Douglas Lumsden’s father had with his wait in an ambulance. It is important that we take action to address the issues. The biggest challenge to flow through our accident and emergency departments is delayed discharges in our hospitals, which prevent patients from moving from A and E into the hospital setting. That is why we are taking concerted action with our health and social care partnerships to address the issues. We are addressing with the partnership in Aberdeenshire particular issues that have arisen there over recent months, so that we see further action.
I assure the member that additional support services have been provided to Aberdeenshire—for example, the Scottish Ambulance Service has put in place additional ambulance resource in Grampian. There are two new double-crewed ambulances in Aberdeen alone, one new night-shift ambulance that is based at Aberdeen central fire station, a fully funded paramedic response unit in Elgin, a new back-shift in Elgin and a new back-shift in Banff. Keith and Huntly ambulance stations are now both operating 24/7.
To allow flow into hospitals, we need to address delayed discharges. We will continue to focus on that with health and social care partnerships.
That concludes general question time.
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First Minister’s Question Time