The next item of business is First Minister’s question time.
Out-of-hours Hospital Services (Skye)
On Saturday, a woman tragically died at a music festival on Skye. At the same festival, 27-year-old Eilidh Beaton nearly lost her life when no ambulances were available. Eilidh told The Press and Journal:
“I was coming in and out of consciousness. My airways were shutting down.”
She said:
“I could not breathe”
and
“At one point I thought if I don’t get oxygen I will not be here tomorrow.”
When we spoke with Eilidh last night, she said:
“We were 200 yards from Portree Hospital. A local coastguard offered to carry me to the hospital but were told there was no point because it was closed—so I would just be left lying outside.”
One life has been lost and another was very nearly lost. Does John Swinney accept that that should never have been allowed to happen?
I agree with Mr Ross that that should never have happened. I express my sincere condolences to the family of the individual who lost their life and I say to Eilidh directly that I am sorry for the terrifying experience that she had on Saturday night.
As Mr Ross will be aware, Portree community hospital is not currently operating as a 24/7 emergency facility. Some years ago, Sir Lewis Ritchie recommended that it should be, and it is a matter of deep concern to the Government that that has not happened. The health secretary spoke with the leadership of NHS Highland yesterday to make it clear that we want that to happen at the earliest possible opportunity.
I want to say something to the ambulance crews and other individuals who supported Eilidh. The Portree ambulance was away from Portree at the time, so ambulances came to Portree from Dunvegan and from Kyle, which, as Mr Ross will know, involves quite a travel time. The ambulances got there as quickly as possible. The individuals who supported Eilidh, including Royal National Lifeboat Institution volunteers and others, have the admiration and appreciation of the Government for the steps that they took to support an individual in our society.
We all have admiration for those who stepped in to help, but it should never have got to that stage. John Swinney says that he has deep concern that the recommendations of the report by Sir Lewis Ritchie have not been implemented. It is far worse than that. The report is from more than a few years ago; it was published in May 2018—six years ago.
The report was an independent external review of out-of-hours health services in Skye, Lochalsh and the surrounding area. The very first recommendation of the review from May 2018 said:
“Out-of-hours urgent care access at Portree Hospital should be provided 24/7”.
It also said:
“there should be no closure of Portree Hospital in the out-of-hours period”.
The report went on to say:
“The Scottish Ambulance Service ... should increase its paramedical staff ... capacity and capability in”
the region.
When we spoke to her last night, Eilidh said:
“The report has been on the table for 6 years saying we need 24 hour urgent care. They keep making these promises but delivering no action, making the same excuses.”
Those are her words, First Minister. Why, in the past six years, have the recommendations of the independent report not been implemented?
I understand the genuine concern that Mr Ross is expressing to Parliament today, and I take that very seriously. Mr Ross is correct that the report came out in 2018, but I point out that there has been a three-year period since then in which 24-hour emergency care arrangements were provided at Portree community hospital; however, they were not able to be sustained because of workforce challenges in the locality. I accept that that is not good enough, which is why the health secretary has spoken to NHS Highland to insist that those arrangements should be put in place.
There is of course a challenge in relation to some workforce issues, because of staff availability and issues in connection with housing availability. I say to Mr Ross that ambulance cover is available in Dunvegan, Portree, Kyle and, of course, at Broadford hospital. However, I do not in any way want to say that that is good enough.
Sir Lewis Ritchie’s recommendations must be implemented, and the health secretary has made that point directly and clearly to NHS Highland. It is a matter of fact that there was a three-year period in which those recommendations were in force, but they have not been able to be sustained because of workforce challenges.
I know that the First Minister is treating the issue sensitively, as I think we all are, but that is no comfort to Eilidh, who thought that her airway was closing. She thought that, if she did not get oxygen, she might not see the next day. She will take absolutely zero comfort from the fact that, in three of the past six years, there was 24/7 care, because when there was a major event in Skye, it was not available.
The First Minister says that the Government will implement the recommendations of the report. Why are we hearing that from him and the health secretary now, and not when the report was published six years ago?
Six years ago, the local MSP for the area, Kate Forbes, said that the situation was “utterly unacceptable” and that the out-of-hours closure was
“another step in the wrong direction”.
This week, the Deputy First Minister said:
“Enough is enough. It has been six years, and the timescales for delivering the recommendations keep shifting.”
That was the Deputy First Minister saying that, and she added:
“there must be accountability”.
We agree, but it is the Scottish National Party Government, in which she serves, that needs to be accountable. Kate Forbes was the Cabinet Secretary for Finance and the Economy for years, and she is now the Deputy First Minister, which is the second-most powerful position in the Government. Where was the will to act before now?
It is not more empty words that are needed—it is action. Why does it take tragic events, such as the ones that we witnessed in Skye on Saturday, for the Government to finally step up and deliver?
I am trying to be as helpful as I can on the question, but it is a matter of fact that Sir Lewis Ritchie’s recommendations were implemented for a three-year period, although they have not been sustained.
I accept that that is not good enough. That is what the Government is addressing. That is why, in the past 48 hours, the health secretary has met directly with the leadership of NHS Highland. He has also met Kate Forbes, who is the Deputy First Minister and MSP for Skye, Lochaber and Badenoch. All those conversations are taking place to ensure that Sir Lewis Ritchie’s recommendations are implemented, and that they are implemented in short order.
I give Mr Ross the assurance that the health secretary and I, as First Minister, will make sure that the issue is progressed. It should not have taken tragedy to get to this point, but I assure Parliament that the issue has the attention of ministers to ensure that it is addressed promptly.
Skye’s health services were once again shown to be deficient at the weekend. Just last Friday, my colleague Jamie Halcro Johnston met campaigners in Portree, before those events happened, because local people and visitors were worried about the situation. They are still worried, and they are right to be worried, because we are getting comforting words but no sign of action.
The action should have happened in 2018. It is as simple as that. We do not ask for independent external reviews and then say that their recommendations are implemented every now and then. The recommended changes were required in 2018, and they have been required for the entire six-year period since then—not just for three years.
The crisis across healthcare in rural Scotland is a concern to people up and down the country. As this incident has shown, there are black spots across Scotland where urgent treatment is often unavailable. There are sometimes no ambulances if people live in the wrong place. There is a postcode lottery for emergency care. This crisis is costing lives and putting people at risk. What action will John Swinney take today to ensure that everyone in Scotland, regardless of where they live, has the same access to the urgent healthcare that they need?
I reiterate to Mr Ross that the recommendations were implemented but were found to be unsustainable. They were implemented for a three-year period; I have accepted that that is not good enough and that the issue must be addressed, which is exactly what the health secretary is doing.
It is important that I put on record the emergency care that is available in Skye. There is an advanced nurse practitioner-led, non-emergency, appointments-based out-of-hours service in Portree hospital, which is available by appointment on Saturdays, Sundays and bank holidays from 8.30 in the morning to 7.30 pm.
There is an accident and emergency at Broadford hospital, which is 30 minutes south of Portree. In addition to that provision, the Scottish Ambulance Service has four double-crewed ambulances that cover Skye, which are based in Broadford, Portree, Dunvegan and Kyle.
There is, however, a necessity for Sir Lewis Ritchie’s recommendations to be implemented. That is exactly what the health secretary has insisted will be undertaken with NHS Highland, and that is what will happen. We will update Parliament about the improvements that are delivered.
National Health Service
After 17 years of this Scottish National Party Government, the crisis in our national health service is deepening. More than 820,000 Scots are on NHS waiting lists; people who are waiting in pain are using their savings or borrowing money from loved ones to pay for private treatment; people cannot get general practitioner appointments; and 169,000 patients have waited more than four hours for treatment in an accident and emergency department since the start of this year.
Now, because of the Government’s financial mismanagement, the NHS and social care services face a black hole of up to £1.4 billion this year. That has led the finance director of NHS Greater Glasgow and Clyde—Scotland’s biggest health board—to warn that spending on every service would need to be reviewed.
Our NHS faces the biggest crisis in its lifetime, but health boards are being asked to make cuts across the country because of decisions that John Swinney has made. Does the First Minister accept responsibility? What will he do to fix the mess that he has made?
It is very important that we have a substantial discussion about the public finances and the context in which we are operating. In Scotland, we are operating after 14 years of austerity that have put insufferable pressure on our public services. Within that, the national health service has been the best financially supported of any service in Scotland.
Anas Sarwar could have come here today to ask me about financial pressures on local government—he would have been right to do so, because there are financial pressures on local government—but he is raising with me financial pressures on the national health service, which is the public service that has been best funded by the Government.
I have set the context for Anas Sarwar’s question, because he and his colleagues have to understand that Scotland is now paying an intolerable price for 14 years of Westminster austerity.
John Swinney and I do not disagree on the fact that we need to get rid of a rotten Tory Government that has destroyed the United Kingdom over the past 14 years—there is no disagreement on that. However, after 17 years in government, there is always somebody else to blame. How about taking some responsibility for the decisions that are made here, in Scotland?
The First Minister made no effort to address the scale of the crisis that our NHS is facing. Instead, he went to his get-out-of-jail-free card, which is to blame the UK Tory Government. His financial mismanagement and the £1.4 billion black hole that it has created will impact on the delivery of every service in every part of the country.
Let us look at the past few weeks’ announcements: Inverclyde’s out-of-hours GP service has been permanently closed, with patients now facing a 50-mile round trip to access overnight appointments; in the city of Glasgow alone, more than 150 jobs have been lost in health and social care services; in North Ayrshire, care homes have been reduced and charges for vulnerable people have increased; and, in Edinburgh, unions have warned that social care cuts will mean that, in their words,
“Thousands of hours of support will be cut; hospitals, care homes, prison cells and morgues will fill up as a consequence.”
Stop passing the buck. Stop looking for somebody else to blame. John Swinney has been at the heart of the SNP Government for 17 years. Is that not a damning indictment of his record?
I will never evade responsibility for my actions as a minister; it is not in my character to do so. However, I will be straight with the Parliament and the public in Scotland.
If anyone wants to look at all the things that I have said on the parliamentary record over the past 17 years, they will find me being straight with people about the financial challenges that we face. I also happen to be a former finance minister who balanced the budget on 10 occasions over the past 17 years. That involved taking difficult decisions to protect our public services, and it resulted in the national health service being the best-funded service among our public services.
We have also had to take some pretty tough decisions, for which I take responsibility, such as increasing tax on higher earners. Mr Sarwar has deserted that territory. Mr Sarwar and Mr Marra no longer believe in that territory. They voted for it once, and they now condemn it.
How does Mr Sarwar believe that we can invest as much as we do in the health service today if we are not prepared to ask people to contribute more in taxation? That gives us £1.5 billion more in revenue at our disposal, because of decisions for which I am absolutely happy to take responsibility. As a consequence of that, we can fund the national health service better than if we had relied simply on the financial settlement from the United Kingdom.
It demonstrates the First Minister’s economic incoherence that he supports higher taxes for nurses but lower taxes for oil and gas giants that are making record profits in the middle of a cost of living crisis.
Our NHS is weaker than ever. Staff are under unbearable pressure and patients are being asked to accept the unacceptable, all because of the decisions that this Government has made.
As Deputy First Minister, John Swinney cut hundreds of millions of pounds from health and social care budgets. He said that he does not want to “evade responsibility” for the decisions that he has made. Let me remind him of just one group of decisions that he made in one year alone.
He cut £70 million from social care while people were stuck in hospital, unable to get a care package. He cut £65 million from primary care services, making it difficult for people to get a GP appointment. He cut £38 million from mental health services, leaving people in crisis waiting for longer to get the help that they need. He raided integration joint board budgets for more than £300 million. Those are the same local services that face funding gaps just now.
I say to John Swinney: do not evade responsibility. Stand up, apologise for the decisions that you have made and recognise why people across Scotland are asking, “How can the man who made the mess now be the one to fix it?”
Always speak through the chair, Mr Sarwar.
It is a bit rich for Anas Sarwar to come to the chamber and criticise me for decisions that I have taken, when he supports a party that wishes to relieve bankers of the obligation to pay into our tax system by lifting the cap on their bonuses. That is a ludicrous position.
This morning, I listened to the contribution from Keir Starmer in which he set out Labour’s policy position. I did not hear Keir Starmer setting out an uplift in public expenditure as a consequence of 14 years of austerity.
Yes, he did.
Let us hear the First Minister.
Mr Sarwar has accepted my point that austerity has been a curse on our society. Despite that austerity, however, resource funding for the national health service has more than doubled since this Government came to office in 2007.
We have taken tough decisions to increase tax in order to invest more in the national health service. We have made the national health service the best financially supported service of all public services in Scotland, and we are absolutely committed to delivering for the national health service.
Anas Sarwar cannot come to the chamber and deny that we have been operating in a significantly constrained public expenditure context and that we have delivered the best settlement that we can for the national health service.
Cabinet (Meetings)
I start by expressing my party’s condolences to the family of Heather Aird, who died after becoming unwell at the Skye Live music festival last weekend. I thank those who attended her and Eilidh Beaton, who, as we have heard, also became unwell.
To ask the First Minister when the Cabinet will next meet. (S6F-03120)
First, I associate myself with the comments that Mr Cole-Hamilton has made about Heather Aird and Eilidh Beaton.
The Cabinet will next meet on Tuesday.
The emergency care system collapsed on Skye last weekend. Eilidh Beaton’s life-threatening anaphylactic shock happened virtually on the doorstep of Portree hospital. Five EpiPens were administered to keep her alive, while lifeboat volunteers hammered on the doors of the hospital, and her boyfriend literally threw rocks at its windows, all because the doors were locked. For six years, the Government has known about the Ritchie report, yet the doors were still locked.
Skye is not alone in the hollowing out of rural healthcare. Just ask the mums who have to drive 100 miles down the treacherous A9 in labour because their local maternity unit in Caithness is closed.
The day before the emergency on Skye, I was in the Highlands, and I called on the new First Minister directly—again—to get the Portree hospital open for emergency care. We keep asking—this is not news to him. Why has it taken six years and a near fatality for his Government to finally lift the phone to NHS Highland about emergency care on Skye?
I have gone through with Douglas Ross some of the issues and the provisions that are in place, but I will go through them again for Mr Cole-Hamilton.
The circumstances at the weekend were unacceptable, and the recommendations of Sir Lewis Ritchie should have been implemented consistently over the past six years. They were implemented for three of the past six years. That is not good enough—it certainly was not good enough at the weekend—so that issue has been addressed directly by the Cabinet Secretary for Health and Social Care in his dialogue with NHS Highland.
Mr Cole-Hamilton raises issues about maternity care in Caithness. As he will understand, we take direct clinical advice about the sustainability of clinical services. It would be inappropriate for the Government not to take seriously the clinical advice that we have about the sustainability and effectiveness of local services. That will always be a priority for the Government.
I want to make clear to the Parliament the importance that the Government attaches—hence the point that I have just made to Mr Sarwar—to the significance of the financial settlement that we give to the national health service and to ensuring that those resources are deployed effectively around the country so that we have effective public services and effective health services available. That is the direction of the Government’s healthcare policy, and that is what we will do and implement on behalf of the people of Scotland.
Sextortion (Awareness)
To ask the First Minister what steps the Scottish Government is taking to raise awareness of the issue of sextortion, in light of the recent issuing of an urgent warning by the National Crime Agency to education providers across the United Kingdom. (S6F-03117)
Keeping children and young people safe from sexual abuse and exploitation, including sextortion, is a priority for the Scottish Government.
We welcome the efforts of the National Crime Agency to raise awareness of that serious harm. We, too, are raising awareness of the risk of sextortion and have provided information to parents and carers on the Parent Club website, which is currently being promoted via social media. Police Scotland is also updating sextortion resources on its website to reflect the new National Crime Agency guidance.
We will continue to work closely with national and UK partners, including the Internet Watch Foundation, Police Scotland, the National Cyber Security Centre and the Cyber and Fraud Centre Scotland, to tackle cybercrime, including sextortion scams.
Murray Dowey from Dunblane tragically took his own life in December after falling victim to sextortion via Instagram. That young man, with his whole life ahead of him, was just 16 years old. Murray’s loss is felt widely in the community, and many are asking how they can protect young people online. Will the First Minister outline the steps that the Scottish Government can take to ensure that social media sites take the safeguarding of young people seriously and, when things go wrong, co-operate fully with the authorities?
I thank Evelyn Tweed for raising that important case. I have watched with incredible admiration the courage of Ros and Mark Dowey in talking about their beloved son, Murray. As the parent of a teenager, I cannot comprehend the scale of loss and the unimaginable suffering that they are experiencing, but I commend their bravery in raising awareness of the threat of sextortion, which has had such a terrible impact on their family.
The Government will continue to prioritise working closely with national and United Kingdom partners to protect children and young people from sexual abuse and exploitation through our membership of Police Scotland’s multi-agency group on preventing online child sexual abuse. In the coming weeks, ministers in the Government will meet the Ofcom board member for Scotland to discuss the implementation of the UK Government’s important online safety legislation, on which we, as a Government, have been deeply engaged. We must all take the efforts that we can to raise awareness of this important issue, to ensure that families and young people are supported to deal with the threats that now exist in our society.
I commend the bravery of Ros and Mark Dowey. They have my deepest sympathy for the loss that they have experienced, and the commitment of my Government to do all that we can to protect young people from crimes such as sextortion and the incalculable suffering that those crimes can inflict on families in our country.
Clyde and Hebrides Ferry Service Contract (Tender Process)
To ask the First Minister, in light of the Clyde and Hebrides ferry service contract expiring in September, when the Scottish Government will publish the tender process for the new contract. (S6F-03119)
The Scottish Government’s priority is to ensure provision of a high-quality service to communities on the Clyde and Hebrides routes. As stated in Parliament on 16 November, the Cabinet has agreed that, subject to the completion of a satisfactory due diligence exercise, the next generation of the Clyde and Hebrides ferry service provision could be awarded via a Teckal exemption to the incumbent, CalMac Ferries Ltd. If an award via a Teckal exemption is confirmed to be the procurement route for the next service provision, a tender process will not be required. Should the due diligence work have an unsatisfactory outcome, we would revert to a competitive tendering process. An update on the preferred procurement route will be provided before the summer recess.
Of course, that is in direct contravention of what islanders wanted and what they told the Net Zero, Energy and Transport Committee. I am surprised that the Cabinet Secretary for Transport, who was a member of the committee when it took that evidence, has not briefed the First Minister about that.
Would the First Minister consider the decision to give the contract to a company whose parent company made a £16 million profit from delivering poor services in 2022-23 to be against the wishes of the islanders?
I have previously heard Edward Mountain commending the contribution of my colleague Fiona Hyslop, the Cabinet Secretary for Transport, to the report of the Net Zero, Energy and Transport Committee—indeed, I seem to recall him speaking so warmly about it that he wondered whether he had damaged Ms Hyslop’s political career and prospects. That was appropriate commendation, which shows why Fiona Hyslop is the Cabinet Secretary for Transport and is undertaking her responsibilities extremely well.
We listen carefully to the views of island communities, and we will continue to do so. I give that assurance to Mr Mountain. As someone who is a regular user of the Clyde and Hebrides ferry services and to whom those services are very precious, I will listen carefully to the views not just of my transport secretary but of islanders, so that I understand the need for them to have access to a high-quality service that will meet their needs as residents and as businesses, and that will enable them to accommodate visitors who access our islands.
Does the First Minister accept that it is now too late to go to tender, which means that, irrespective of the outcome of the due diligence process, it will be necessary for CalMac to continue to provide the service after September, and that it is therefore only fair to let CalMac know that as soon as possible?
As I said in my original answer to Mr Mountain, an update on the procurement route will be given before the summer recess. It will provide the clarity that Katy Clark reasonably asks for and will give certainty to island communities at that time.
It is my understanding that the consultation ran for 12 weeks and closed in early March. Does the First Minister share my view that the voices and views of islanders and other ferry-dependent communities must be central to the process and that it is vitally important that the Scottish Government to take the required time to study the responses and to fully appreciate what it is being told?
That dialogue is essential, as is the dialogue with the ferries community board, and those will significantly shape the dialogue that the Government takes forward on those important questions. I give Jackie Dunbar the assurance that we will take the necessary time to ensure that all those issues are properly explored before final decisions are taken.
Whether it was by direct award or by tender, the previous tender process was little more than a beauty parade with an inevitable outcome. Before we again hand the tender to CalMac on a plate, can we ensure that it delivers on the 350 overt commitments that it made last time it won the contract, of which more than 30 are yet to be delivered?
I am very much in favour of making sure that the expectations of communities are met in contract arrangements, and ministers will insist on that, so that we have a high-quality and reliable service for island communities. I am committed to ensuring that that is the case.
Whooping Cough
To ask the First Minister whether he will provide an update on any risks presented by whooping cough in Scotland, in light of reports of increased infection rates and infant deaths in the United Kingdom. (S6F-03123)
I am sure that Parliament shares my concern at media reports of the tragic loss of five young lives as a consequence of whooping cough. Those deaths occurred in England, but Public Health Scotland has confirmed that notifications of whooping cough—or pertussis—in Scotland have increased since the beginning of the year and that the number of laboratory-confirmed cases is likely to rise in line with that.
Pertussis is spread by respiratory droplets, either directly between people or via contaminated items. Young, unimmunised children and babies are particularly at risk of severe illness. The infection can be prevented by immunisation, so I encourage parents to ensure that younger children and infants are immunised. Pregnant women should also receive the vaccine, which provides vital protection for the first few weeks of their baby’s life.
The First Minister is right to say that five babies in England have, tragically, died of whooping cough after a surge in infection rates there. He has also confirmed that a similar surge is already under way in Scotland.
Vaccination can protect babies, pregnant mothers and, importantly, their unborn children. It is worrying that the uptake of infant vaccinations appears to have fallen in recent times, with babies from the most deprived areas, including parts of my Maryhill and Springburn constituency, being less likely to be vaccinated.
Will the First Minister work with national health service boards right across Scotland to ensure that every effort is made to support midwives, health visitors and local vaccination teams to maximise uptake at this crucial time, as well as considering what steps our NHS can take to address the more general dip in vaccination rates right across Scotland?
I completely understand the concern that Mr Doris brings to Parliament. Immunisation is the most reliable way to protect babies in the early weeks of life. The chief midwifery officer is writing to maternity services to encourage and promote pertussis vaccination for pregnant women—doing exactly what Mr Doris has asked me to commit to. I will encourage the chief midwifery officer to support the awareness-raising efforts that are essential to ensuring that maternity services deliver that message to pregnant mothers and that vaccination uptake increases. We all know the importance of vaccination efforts and I give Mr Doris a commitment that the health service will follow exactly the approach that he has suggested to Parliament today.
As has been said, statistics from England and Wales show that the uptake of immunisation against whooping cough during pregnancy has reduced sharply. As the First Minister has indicated, immunisation is important for expectant mothers. Do we know whether the trend is similar in Scotland? The First Minister mentioned some relevant responses, but will he work with Public Health Scotland to ensure that specific statistics on that are published, so that we can properly scrutinise the uptake by pregnant mothers?
I will explore the point that Carol Mochan puts to me. The data that I have on immunisation uptake from Public Health Scotland, which was published on 26 March, indicates an increase in uptake in relation to some vaccinations but, from the information that I have, I do not think that that is specifically about pertussis. I will give Carol Mochan a specific answer, but generally, on immunisation, the uptake is moving in the right direction, which we all want to see. I will provide a specific answer on pertussis in the aftermath of First Minister’s questions.
Affordable Housing (Rural and Island Areas)
To ask the First Minister, in light of reports that only four homes have been approved nationally under the affordable housing initiative for key workers scheme, whether he will provide an update on what efforts the Scottish Government will make to address the reported housing crisis in rural and island areas. (S6F-03136)
Between April 2016 and March 2023, we have delivered more than 10,000 homes in rural and island areas. We are working with local authorities and registered social landlords to encourage utilisation of the £25 million key workers homes fund where there are identified local requirements. I am pleased that three local authorities are actively looking to bring forward proposals in rural communities. We will invest nearly £600 million in affordable homes across Scotland this year, including significant investment in rural and island areas through our mainstream affordable housing supply programme, as well as our demand-led rural and islands housing fund and rural affordable homes for key workers fund.
I have spoken to NHS Highland on numerous occasions about health services at Portree hospital in the Isle of Skye. Each time I do so, it comes back to me saying that it can recruit, but the people whom it recruits cannot find a home and so cannot take up the post. Therefore, the First Minister will understand my concern that the £25 million Government fund to provide key worker housing has bought only four homes. What is wrong with the scheme? Why is it not working? Will he take matters into his own hands and fully implement the recommendations of Sir Lewis Ritchie’s report? Will he ensure that those key workers have homes to live in in Skye?
I share the aspirations that Rhoda Grant has put to Parliament today. NHS Highland has a close working relationship with Lochalsh and Skye Housing Association, which has supported NHS Highland in providing housing for key staff in Broadford. Four flats have been leased for nurses, three of which are supporting the international recruitment project that brings skills into the locality to meet some of the shortages that we are experiencing. The remaining flat is used for on-call staff. The board also leases two family homes for specialist staff located at the new Broadford hospital. All houses and flats in that development are fully occupied.
I hope that that reassures Rhoda Grant that, where these projects come forward, they are fully utilised and deployed. There is an invitation to public bodies to come forward with proposals to access the fund. The fund has not been fully utilised, so, from this podium, I encourage public authorities to come forward with their bids to address some of the issues that Rhoda Grant raises.
The issues that Rhoda Grant raises underpin the issues that Mr Ross and Mr Cole-Hamilton raised with me today about having accommodation available for staff in rural areas. I acknowledge that that is a problem. My long-term leadership of the convention of the Highlands and Islands over many years in government taught me that important lesson about the interconnectedness of housing. I encourage public authorities to come forward on the measures that will address those issues.
Access to affordable housing remains one of the key factors driving depopulation in our islands. There has been significant Scottish Government investment in recent years, but can the First Minister say more about the Scottish Government’s approach to working with key stakeholders to ensure that empty homes are brought back into use and that enough new homes are being built in both rural and urban areas of the Highlands and Islands?
I recognise the importance of good-quality affordable housing in rural and island communities to address some of the public service delivery challenges that exist.
Dr Allan and I have discussed that issue on many occasions in taking forward issues in relation to the islands. We are working to increase the supply of affordable housing in rural and island areas. An investment of £3.7 million has been made in the Scottish empty homes partnership, which is making a real difference, with more than 9,000 homes having been brought into use since 2010. I want to see all local authorities and partners working together to consider all available options. The Government will be very much part of that discussion. The Minister for Housing, Paul McLennan, who is listening to these exchanges, will take forward the issue as a priority in order to ensure that we address the challenges that exist in many of the communities that Dr Allan represents.
A freedom of information request has revealed that Scottish National Party ministers have no idea how many houses will be built in Scotland in the coming years. Under the Scottish Government’s national planning framework, record low levels of land are coming forward in the development pipeline. What urgent steps will ministers take to review the Scottish Government’s national planning framework? Why are ministers being so slow to take forward permitted development rights to build new homes in rural and island communities?
Mr Briggs needs to be aware of the Government’s record on housing—[Interruption.]
Members, let us hear the First Minister.
Let us look at the data. I am all for helpfully bringing data to the Parliament to inform parliamentary proceedings—it is part of my commitment to open government. Since 2007, 40 per cent more affordable homes have been delivered per head of population in Scotland than in England, and 70 per cent more than in Wales. [Interruption.]
I will repeat that so that everyone can hear it: 40 per cent more affordable homes have been delivered per head of population in Scotland than in England, and 70 per cent more than in Wales. Scotland’s overall new house build completion rate in 2022-23 increased to 43 homes per 10,000 people. That was higher than the number in Wales, which was 18, and higher than the number in England, which was 38.
The Government is determined to ensure that we put the resources in place and activate private investment so that we can deliver the houses for people, because the Government has a formidable record on housing construction, which we are proud to proclaim to the people of Scotland.
We will move to constituency and general supplementary questions.
Nuclear Reactors (Plans)
This week, the Secretary of State for Scotland confirmed that planning is under way to develop new nuclear reactors in Scotland—[Interruption.]
Let us hear Ms Mackay.
—despite opposition from the democratically elected Scottish Government. Scotland does not need expensive nuclear power; we already have abundant natural energy resources. Can the First Minister advise whether the United Kingdom Government has approached Scottish ministers about those apparent plans? Can he confirm that the Scottish Government will oppose those plans and, instead, focus on Scotland’s substantial renewable energy potential?
I am often lectured in the Parliament about the importance of good intergovernmental relations. The Secretary of State for Scotland has made no mention of the proposal to the Scottish Government. That is utterly and completely incompatible with good intergovernmental working and is illustrative of the damaging and menacing behaviour of the Secretary of State for Scotland.
The Scottish Government will not support new nuclear power stations in Scotland. I was in Ardersier on Monday and the Cabinet Secretary for Net Zero and Energy was in Nigg on Tuesday to support the announcements of formidable investments in Scotland’s renewable energy potential. Those are massive investments that will bring jobs and opportunities to the Highlands and Islands and deliver green, clean energy for the people of Scotland. That is the Government’s policy agenda, and we will have nothing to do with nuclear power.
Toll of Birness
Yet another crash at the notorious Toll of Birness last week resulted in four people in hospital and the road closed for hours. Promises to upgrade that junction date back to before 2007, when Alex Salmond said that his first decision, if elected as First Minister, would be to deal with that road. Seventeen years on, the promise is broken and there is continued carnage. Will the new SNP First Minister deliver on the promises that all previous SNP First Ministers have broken?
I will happily take forward the issues that Mr Kerr has raised with me today. The Government has an infrastructure programme that is taking forward developments around the country. I will look at the particular project that Mr Kerr has put to me and consider the position of that project in the Government’s capital programme.
NHS Tayside
Board papers have revealed that the Scottish Government has demanded £54 million of cuts in this financial year from NHS Tayside. Officers have presented the board with options. One option is the removal of three operating theatres in a ward, which would mean 3,000 additional people missing out on vital operations this year. Another option is the end of breast cancer screening in a department that has been in crisis for years, resulting in an inevitable decline in detection and the loss of life. Which should they choose, First Minister, or will you act to ensure that those consequences do not fall on your constituents and mine?
Always speak through the chair.
Mr Marra raises important issues about the sustainability of health service provision, and the Government must live within the financial resources that are available to it. It is ludicrous for Mr Marra to come here with that question. I have gone through with Mr Sarwar the fact that the health service is the best funded part of our public services. It occupies a larger proportion of our budget than it did when this Government came to office.
In 2007, when this Government came to office, health service expenditure accounted for about 30 per cent of our total budget. That is now much closer to 50 per cent. The Government has substantially increased expenditure on health. To fund that, we have increased tax on higher earners. Mr Marra is opposed to that; he wants to make the situation worse. Mr Marra wants to reduce the amount of revenue that is available, but he wants me to fund more public services. Mr Marra cannot have his cake and eat it.
Mental Health
It is mental health awareness week, and the theme is “moving more for our mental health”. We all know how important exercise can be for mental health, so the Scottish Government’s recent investment of a further £100,000 in the football-focused mental wellbeing changing room programme is very welcome. Will the First Minister say what other steps the Government is taking to support mental wellbeing and resilience in the community?
It is important that we all, where we can, take responsibility to look after ourselves. This morning, at 6 o'clock, I was running through the streets of Edinburgh to support my mental wellbeing, because I tend to find that I have a better time at First Minister’s question time if I have run in the morning than if I have not run in the morning—every week, members will be able to tell whether I have been out running in the morning.
Mr MacGregor raises a very significant issue. Through our communities mental health and wellbeing fund for adults, we have made available £66 million for community projects since 2021. The fund, which supported approximately 300,000 people across Scotland in its first year, is focused on addressing a number of mental health and wellbeing concerns within local communities in Scotland. Since 2020, we have also made available £65 million to local authorities to develop community support projects, and the Government remains committed to doing the work and supporting the work that Mr MacGregor raised to assist in that respect.
The health secretary was in Aberdeen yesterday to launch the changing room programme, which is a welcome contribution to our efforts on mental health and wellbeing.
That concludes First Minister’s question time. There will now be a short suspension to allow those leaving the chamber and public gallery to do so before the next item.
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