Rural Affairs, Land Reform and Islands
Good afternoon. The first item of business is portfolio question time, and the first portfolio is rural affairs, land reform and islands. I remind members that, as questions 2 and 6 have been grouped together, I will take any supplementaries to those questions after both have been answered. Members who wish to ask a supplementary question should press their request-to-speak button during the relevant question.
Water Management (Financial Support)
To ask the Scottish Government whether it will provide an update on what new financial support will be available to farmers and land managers to manage water, including to prevent flooding of homes. (S6O-03292)
Improving resilience to flooding is a priority for the Scottish Government, which is why we promised to address the issue in our programme for government. Consequently, on 23 April, along with Ms Slater, I will host a round table on water resource, to discuss with stakeholders and individuals how we mitigate and adapt to climate change and the impact of extreme weather events on Scottish agriculture.
In response to storm Babet last year, we provided grants of up to £30,000 to farmers and land managers to help them to repair damaged flood banks. Support is also available to farmers and land managers through the agri-environment climate scheme. Since 2015, the grant that has been issued for options that support the management of water has amounted to £8.1 million.
In addition, we are supporting local authorities with £42 million a year—£150 million over the parliamentary session—to invest in improved flood resilience for local communities, and we will be consulting on a flooding resilience strategy.
All of what the Government is doing is incredibly slow, and none of the money from the agriculture budget that the minister referred to is to do with flooding. All of it is to do with water scarcity and riverbank management, which is not to do with flooding.
For a long time, a wealth of evidence has existed on managing waterways and managing the land. What practical measures will come out of the meeting on 23 April that the minister mentioned? Where are the river catchment management plans? Where are the grants? Where is the clear guidance? Farmers need such guidance in order to better manage their land.
We will discuss all those issues at the flood forum, as I have already mentioned.
I say to Willie Rennie that we are in a season that has been absolutely horrendous for the farming community—this spring has been brutal. If you do not mind, Presiding Officer, I will make a couple of points. I ask members of the farming community to please stay connected and talk to friends and family. Farmers’ mental health is at its lowest ebb at the moment, as a result of a lack of sleep, very long and tiring hours, and nature doing its damnedest to test every nerve and sinew.
I am well acquainted with that feeling, which is why, at the weekend, I went to help a friend in a lambing shed—not with the physical work aspect, but to make sure that he had someone else to talk to. We understand that flooding issues are a problem, but we are tackling them and doing everything that we can to give the farming community mental health support.
I will allow a couple of supplementaries, which will need to be brief, as will the responses.
It is clear that dealing with the impact of flooding and adverse weather is challenging. It is affecting lambing and crop sowing and growth, and it is taking its toll on animals and people, including those in my constituency of Carrick, Cumnock and Doon Valley. What advice and support can the minister offer to farmers and crofters, who are enduring one of the most difficult springs that we have experienced? Given how important land management and flooding are, will he undertake to come back to the chamber to inform members of the outputs from the meeting that he mentioned in his answer to Willie Rennie?
Absolutely—I commit to coming back to the chamber and setting out the outcomes.
I reiterate to my colleague Elena Whitham that, as I said to Willie Rennie, things are really tough at the moment. If people are finding it hard and they need someone else to talk to about the problems that they are facing, I would direct them to the RSABI, which does amazing work in keeping folk’s spirits up and giving practical help and advice on most situations. Its support is available seven days a week, 24 hours a day. People should not feel as though they are on their own, because there is help out there.
When it comes to supporting farmers and landowners to protect riverbanks, the Scottish forestry grant scheme falls way short of England’s woodland creation offer. Just over the border from my constituency, uplift payments for riparian buffers are £2,500, whereas in Scotland, they are just £230.
If, as you say, minister, your Scottish National Party Government takes flood mitigation and prevention seriously, why are you short changing people and scrimping on schemes that support people to do exactly that?
Through the chair, please, Ms Hamilton.
The Government has increased the fund. I am happy to come back to the member with the detail later.
Livestock Worrying
To ask the Scottish Government what action it can take to reiterate the harms caused to both livestock and farmers by livestock worrying. (S6O-03293)
The Scottish Government recognises the distress and the serious welfare and financial implications that livestock worrying causes. We continue to consider education a key factor in reducing the number of incidents. The campaigns that have been undertaken in partnership with NatureScot and the Scottish Society for the Prevention of Cruelty to Animals have reiterated the importance of responsible dog ownership.
Our support for Emma Harper’s Dogs (Protection of Livestock) (Amendment) (Scotland) Bill gave a clear indication of how seriously we take livestock worrying incidents. Should they be convicted of an attack or of worrying livestock, irresponsible owners, who are in the minority, could be fined up to £40,000 or face prison for up to 12 months.
I thank the Government for having supported my member’s bill.
Cammy Wilson is a sheep farmer in the South Scotland region who is doing excellent work to increase awareness of the seriousness of livestock attacks from an animal welfare perspective as well as a health and wellbeing perspective for the farmer. What consideration might the Government give to a national awareness-raising campaign to ensure that the menace of out-of-control dogs and livestock worrying is treated with the utmost seriousness that it deserves to have in the minds of the public?
I take on board all the points that Emma Harper has made. I have watched Cammy Wilson’s videos, which are pretty brutal. If anyone has any doubt as to what a small family pet can do, they should watch his video of a spaniel worrying lambs—it is distressing.
The Scottish Government recognises the effects on animal and human welfare that livestock worrying has—the effects are not just financial but on the wellbeing of those who are responsible for the livestock. The Scottish Government firmly believes that education is key. We want everyone, including dog owners, to enjoy the countryside via their access rights, and I encourage everyone to familiarise themselves with the Scottish outdoor access code.
Livestock Worrying
I think that I have to ask the lodged question first.
To ask the Scottish Government what action it is taking to reduce the number of cases of livestock worrying. (S6O-03297)
I take the question in the spirit in which it is meant. Any dog attack is one too many, and increasing awareness is a key factor in the prevention of livestock worrying incidents and the associated unnecessary suffering.
We continue to work with partners, including NatureScot, whose message on responsible dog walking is generating some 3 million impressions of and 15,000 visits to the Scottish outdoor access code website every year. We also continue to work with Police Scotland, local authorities, the Scottish Society for the Prevention of Cruelty to Animals and other relevant interests to keep communities safe from the small minority of irresponsible dog owners and their dangerous dogs.
In 2021, the Scottish Government supported the introduction of Emma Harper’s Dogs (Protection of Livestock) (Amendment) (Scotland) Bill, which delivers greater powers to Police Scotland and the courts to deal with irresponsible dog owners.
I agree with the minister on the need to raise public awareness about livestock worrying, which causes significant distress and even death, but the law must also be a deterrent. My colleague Rachael Hamilton has established that there were only 21 convictions for that crime in the two-year period to last November. How many reports of livestock worrying were made to the police in that period? Does the minister think that the law is protecting farmers and their livestock?
Unfortunately, that changes the tone. I point out to the member that we have the law in Scotland, which Westminster is only just beginning to follow up on and copy. I cannot give him a definitive number now; we will come back to him with that.
I re-emphasise to people who walk their dogs in the countryside that they should please take a moment to look at the potential damage, that they can watch Cammy Wilson’s videos and see what pets can do to livestock, and that they should make sure that they keep their dog under control when they are among livestock.
Land Reform (Scotland) Bill
To ask the Scottish Government whether its Land Reform (Scotland) Bill will help protect communities from development on land of public importance. (S6O-03294)
The Land Reform (Scotland) Bill will ensure that the benefits of land ownership and decisions about how land is owned, managed and used are more widely shared. The owners of very large landholdings will have to engage with local communities about how their land is used. The bill also seeks to empower communities with more opportunities to own land, through introducing advance notice of certain sales from large landholdings.
The bill does not include reforms to development management, which is a matter for the planning system. Development plans guide the development and use of land in the long-term public interest.
Land in Bathgate that was home to a war memorial and a site where veterans scattered their ashes has been the subject of repeated planning applications, which the council has denied. The developers have repeatedly appealed to the Scottish Government, despite previous appeals for less substantial proposals being rejected. Will the cabinet secretary outline the steps that the Scottish Government is taking to prevent vexatious appeals and ensure that communities in all parts of Scotland have a say in how land is used?
I am not aware of the details of the specific incident that the member mentions, but I am more than happy to look into it. It sounds like a matter that should probably be raised with the planning minister, but I am more than happy to follow it up with the member.
One thing that I would note, particularly when we are talking about significant pieces of land in communities, is that the changes that were introduced in the Planning (Scotland) Act 2019 put community voices at the heart of the planning system. Before preparing a local development plan, planning authorities now have to invite local communities to prepare local place plans. That is where such significant issues can be considered. As I said, I am more than happy to follow up with the member and the relevant minister.
Over the years, we have all seen examples of sales of whole islands or other large estates causing real issues for the people who live there. What steps is the Scottish Government taking to give island residents greater protection from having their communities and, often, their livelihoods being bought and sold in that way?
The member raises an important point, which is why the measures that we are introducing as part of the Land Reform (Scotland) Bill are so important. The bill will prohibit certain sales of land of more than 1,000 hectares until ministers can consider the impact on the local community. That could lead to some landholdings being lotted into smaller parts.
We believe that the bill will empower communities. It will give communities more opportunities to own land by introducing advance notice of certain sales, and the owners of large landholdings will have to engage with local communities on their plans for the use of the land. Those requirements will apply if a landholding is more than 25 per cent of a permanently inhabited island and if it exceeds 1,000 hectares. I believe that the measures that I have mentioned, as well as the wider proposals that the bill introduces, will benefit many of our island communities.
American Mink (Wildlife Management)
To ask the Scottish Government how its work on wildlife management can help address the reported threats to nature and biodiversity restoration posed by American mink. (S6O-03295)
American mink is an invasive non-native species that is contributing to the decline of Scotland’s vulnerable native species. The Hebridean mink project shows how investment of £250,000 per year since 2001 has achieved eradication, or very low populations, of mink in the Hebrides to allow ground-nesting birds and wider biodiversity to recover and thrive.
Through the nature restoration fund, the Scottish Government is providing £2.5 million to the Scottish invasive species initiative and biosecurity for Scotland’s seabird islands project to train and work with communities and volunteers to control non-native species, including mink, to allow biodiversity to recover.
Controlling mink requires extensive surveying of rivers and burns to be carried out by volunteers. What is being done to recruit volunteers in the north-east, where mink are a particular threat?
The Scottish invasive species initiative has a dedicated team of around 155 volunteers working on mink control across north-east Scotland. With the aim of building on its success, the SISI has put out a call for more volunteers to tackle mink in an expanded area across northern Scotland. The project will train the new volunteers to operate innovative smart traps and mink rafts to survey for mink. I recognise the hard work and dedication of all the SISI staff and volunteers who are tackling invasive non-native plants, as well as mink, across northern Scotland.
Register of Persons Holding a Controlled Interest in Land
To ask the Scottish Government what assessment it has made of the impact of the register of persons holding a controlled interest in land since it launched on 1 April 2022. (S6O-03296)
The register of persons holding a controlled interest in land, which is known as the RCI, is maintained by the keeper of the registers of Scotland. The RCI went live on 1 April 2022, with a two-year transitional period before the offence provisions for non-compliance took effect.
As of 12 April 2024, 12 days after the end of the transitional period, there were 5,438 entries on the RCI. A further 10,273 entries have been submitted and are pending publication, as details are not published until 30 days after submission to the register.
When Russia invaded Ukraine on a full-scale basis in 2022, there was, rightly, a focus on the Russian oligarchs who own land in Scotland. We know of four such people and that at least two of them have links to the Kremlin and were included on the Putin list that the US Department of the Treasury published in 2018. However, a loophole in the register means that some landowners are exempt from it, which could mean that landowners who may have links to Putin’s kleptocracy are still hiding their identity and potential wealth. Is the cabinet secretary satisfied with the existing system? What are the Government’s plans to increase transparency on the issue?
The measures that we have introduced are very important ones, but, as with anything, as things progress, if there are any improvements to be made to the system, the Government is open to looking at what those might look like and to engaging with the member on the discussions.
I note that this is an area of interest for the member. I think that, in previous responses on the issue, I have outlined that we fully supported the United Kingdom-wide emergency legislation that was introduced under the Economic Crime (Transparency and Enforcement) Act 2022, which was about the register of overseas entities.
I believe that we are making strong progress on the issue, but I am more than happy to keep the matter under review.
There are a couple of supplementary questions.
Cabinet secretary, my query may be too specific for an immediate response. A constituent of mine represents the Glencorse Centre, which is a Scottish charity that is also registered as a UK company limited by guarantee. He is not clear whether, under the guidance, he is required to register the charity as having a controlling interest in land.
I would be happy to receive a written answer if the cabinet secretary cannot clarify the position now.
I would be more than happy to follow up with the member on the particular circumstances that she has mentioned. I encourage the organisation to which she referred to get in touch with the Registers of Scotland, which should be able to clarify the position and offer some advice. If members are receiving similar queries, I would encourage them to get their constituents to do that, too.
When land is owned through a company and the controlling interest of the company changes, is the register updated automatically? Can triggers be fitted to the system, given that the Land Reform (Scotland) Bill might require that in the future?
I am more than happy to follow that up afterwards and provide responses to those queries.
Agricultural Funding Post-2025
To ask the Scottish Government what recent engagement it has had with the United Kingdom Government regarding Scotland’s agricultural funding post-2025. (S6O-03298)
Brexit means that we no longer have long-term certainty of funding. His Majesty’s Treasury has provided only yearly allocations for the current UK parliamentary term, and, as it stands, we have no funding commitment from 2025.
The Scottish Government has made repeated requests to UK ministers to engage on the matter, including sending several letters to Steve Barclay since his appointment as the Secretary of State for Environment, Food and Rural Affairs. We are still waiting for a response to those requests.
The Scottish Government has been clear and consistent that we expect the full replacement of European Union funds to ensure that there is no detriment to Scotland’s finances.
Everything about Brexit is last minute. In my constituency, small food producers are now facing a huge hike in fees for imports, which is threatening their viability, and trade bodies are warning about the risk of a hike in food prices. Does the cabinet secretary agree that it is time for Scotland to escape the unrelenting harm caused by the Westminster Government’s irrational adherence to a Brexit that is breaking our economy?
I thank the member for raising that important point, particularly about the recent checks that were introduced. The Scottish Government had agreed to implement the UK Government border target operating model, which is, ultimately, to ensure that we protect our people, businesses and the environment from the biosecurity risks that come with different products entering the country.
Throughout that process, we have worked pragmatically to balance the need for introducing those controls with minimising burdens on traders. However, since publication, the Scottish Government has been locked out of key discussions; we have been asked to make important decisions at very short notice; and we have been faced with the UK Government making unilateral decisions in areas of devolved competence.
Fundamentally, Brexit is the reason that new checks are needed on imports from the European Union and Scotland is now paying a very high price for a Brexit that it did not vote for. We have repeatedly called for the UK Government to sign a veterinary agreement with the EU, which would remove those barriers. Ultimately, the Scottish Government continues to believe that the best trading relationships for Scotland will be found when we are an independent member of the EU in our own right.
The cabinet secretary may stand on her soapbox, blaming uncertainty on the UK Government, but the fact is that the UK Government has provided multiyear, ring-fenced funding since the UK left the EU and has also uplifted payments after the Bew review. It is the Scottish Government that continues to raid the agricultural budget. It is clear to farmers—but perhaps not to the cabinet secretary—that this Government is wholly responsible for the uncertainty surrounding future farm payments through not publishing the future rural support plan. Can the cabinet secretary set out exactly when the working draft of the plan will be available?
First, there are a number of points of misinformation there that I would be happy to clarify for Finlay Carson. The UK Government provides funding on an annual basis. Rather than having the seven-year block funding that we previously had as members of the EU, which came through as a mixture of resource and capital, we now receive funding on an annual basis and only as resource funding. We are not receiving any of it as capital replacement.
We have also received the worst budget settlement since devolution, with significant cuts to our capital budget of around 10 per cent, which means that we have had to make difficult choices. However, the ring-fenced funding—I think that it is important to clarify this, since the Tories continue to perpetuate this misinformation—will be returned in full to the portfolio, as has been committed to by me, by the Deputy First Minister and by the First Minister himself. The nature of that funding is ring fenced, which means that it must be returned to the portfolio—£15 million of it has been returned this year.
Marine Tourism (Crown Estate Scotland)
To ask the Scottish Government how Crown Estate Scotland supports marine tourism in coastal communities. (S6O-03299)
Since 2020, Crown Estate Scotland has distributed more than £1.4 million through its sustainable communities fund to support local regeneration and development, including several marine tourism projects.
Crown Estate Scotland has three community marine officers in place to enable Scotland’s people and communities, along with visitors, to make the most of our coastal waters. It also co-funds a marine tourism officer in Mr Gibson’s own constituency.
Since 2019, over £50 million in revenues from Scottish Crown Estate marine assets have been allocated to local authorities for local spending to support priorities in their areas, including tourism.
In June 2021, Crown Estate Scotland earmarked £3 million for boat-based tourism. In my constituency, Millport marina—an Ayrshire growth deal project—is reliant on that funding, given the impact of inflation on other funding streams. Despite a duty to support coastal communities, Crown Estate Scotland recently reneged on its commitment to support marine tourism. Can the cabinet secretary advise us on how local stakeholders can help the Crown Estate to deliver its stated objectives to islands such as Cumbrae?
I thank the member for raising that important point. Ultimately, Crown Estate Scotland’s fundamental role is to maintain and enhance the value of the Scottish Crown estate. That is a key aspect, which is included within the criteria when assessing the investment proposals of the bids in relation to the particular scheme that the member is talking about.
Criteria also include the nature of the investment and how it aligns with Crown Estate Scotland’s statutory duties, how it delivers wider sustainable development benefits, financial value and requirements relating to fair competition. I know that applications to the fund are still undergoing assessment, and I know that additional information has been requested from applicants to ascertain whether their investment proposals meet the fund’s criteria, so, at the moment, I cannot comment on specific bids. However, I know that Crown Estate Scotland has been engaged in dialogue with the applicants to the fund and I would also encourage anyone to engage with Crown Estate Scotland directly regarding any specific issues or queries around the fund and the processes.
That concludes portfolio questions on rural affairs, land reform and islands. There will be a brief pause before we move to the next item of business to allow members on the front benches to change over.
NHS Recovery, Health and Social Care
The next item of business is portfolio questions on national health service recovery, health and social care. If a member wishes to ask a supplementary question, I invite them to press their request-to-speak button during the relevant question.
Health Secretary (Meetings)
To ask the Scottish Government when the health secretary last met with the chief executives of NHS Greater Glasgow and Clyde and NHS Ayrshire and Arran, and what was discussed. (S6O-03300)
Ministers and Scottish Government officials regularly meet representatives of all health boards, including NHS Greater Glasgow and Clyde and NHS Ayrshire and Arran, to discuss matters of importance to local people.
Here is something that is of importance: the referral to treatment waiting time standard is 18 weeks, yet, in NHS Greater Glasgow and Clyde, just 68 per cent of patients have been seen within that time. In NHS Ayrshire and Arran, it is only 66 per cent. Over a third of people in my region are waiting for more than four months to start treatment. Those health boards have not met the target, or anywhere near it, for nearly a decade. The problem is that people are dying while they are waiting for treatment. The big question is this: when will those health boards meet those targets, if ever? How many more people will needlessly die while they are waiting for treatment?
First, I say that it is not just regrettable—I am very sorry for all those who are having to wait too long to receive the treatment that they need. We are not complacent about that; as Jamie Greene will have seen, we are investing £30 million of the first tranche of the £300 million that the First Minister committed to in order to tackle the longest waits. We have seen some improvements. A number of specialties have eradicated all out-patient waits over two years, and many have made significant progress compared to 30 June 2022. That includes gastroenterology, where they are down by 99 per cent; general surgery, where they are down by 91 per cent; general practitioners, where they are down by 83 per cent; and ear, nose and throat, where they are down by 97 per cent. In-patient day-case activity for quarter 3 last year was at its highest since the start of the pandemic.
Jamie Greene is right to point to the fact that there are still too many people who are waiting for too long. However, there have been improvements and recovery is happening. We will continue to invest in order to make sure that that continues to be the case.
The adult eating disorder service in Glasgow works with people who have anorexia and bulimia, both of which have the highest mortality rate of all mental health conditions. I understand that the contracts for five key roles in that service are due to end in the coming months. Did the cabinet secretary discuss that issue in his most recent meeting with NHS Greater Glasgow and Clyde? Will he commit to adding that to the agenda for his next meeting?
That is not an issue that was discussed the last time I met the chair or the chief executive. However, I would be more than happy to write to Paul Sweeney about that in more detail.
Gender Dysphoria (Model of Care for Children)
To ask the Scottish Government whether it will review the current model of care for children with gender dysphoria. (S6O-03301)
The Scottish Government is already supporting NHS Greater Glasgow and Clyde, as provider of the young people’s gender service, and NHS National Services Scotland to consider how best to provide specialist young people’s gender care in Scotland. That is part of the implementation of the “NHS gender identity services: strategic action framework 2022-2024”. Last week, the independent review of gender identity services for children and young people, chaired by Dr Hilary Cass, published its final report. The findings of the review into services in NHS England are being closely considered by both the Scottish Government and wider partners.
The minister will be aware of my efforts to secure a ministerial statement on the Cass review, as a portfolio questions session is not enough time in which to scrutinise a near-400-page report. The Scottish Government may not wish to talk about the issue, but parents, campaigners and young people deserve answers. I ask the minister a simple yes or no question: will the Scottish Government adopt the recommendations of the Cass review, including limiting the use of puberty blockers and cross-sex hormones?
As Meghan Gallacher pointed out, it is a long report but very much worth reading. It is very accessible and I encourage as many people as possible to read it. We—the Scottish Government, our officials and our senior clinicians—are all looking at what the report contains and we will give an initial view on that as soon as possible.
I fully associate myself with the minister’s answer and with Dr Hilary Cass’s comments that the
“increasingly toxic, ideological and polarised public debate ... does nothing to serve the ... young people”
who access that care. Instead, our focus should be on supporting and improving gender identity healthcare. What steps is the Scottish Government taking to improve access to and delivery of national health service gender identity services for all, including children and young people?
I note that behind every headline there are children, parents, carers and clinicians who are all impacted. I agree with Bill Kidd and reiterate the Government’s absolute commitment to improving the lives of trans people living in Scotland. In order to improve access to and delivery of gender identity healthcare in Scotland, we have invested more than £2.8 million since December 2022, of which £2.2 million is being allocated directly to NHS health boards with gender identity clinics to support local improvement work—in particular, to address waiting times and service capacity.
As I said, we are working with Healthcare Improvement Scotland to develop national standards for gender identity healthcare and we are supporting NHS National Education Scotland to develop new training materials for staff.
The publication of the Cass review is undoubtedly significant. I know that the cabinet secretary and the First Minister have continually said that they will leave the decision to the clinicians but, ultimately, the Scottish people expect the Government to step up and make a decision on whether it will implement well evidence-based recommendations to protect Scottish children. If not, why not? I ask the minister not whether, but when, a statement will be made to Parliament on this important issue so that members have time to discuss it.
I reiterate that the Government, our officials and senior clinicians are reviewing the report. I do not think that it is appropriate to respond quickly. We have to do that in the appropriate time, so that we understand exactly what the implications are of the Cass review to gender identity services in Scotland. I want to make sure that we put the children, their families and the clinicians at the centre of that work.
Many people will be watching the chamber this week as MSPs discuss their healthcare. I want to send solidarity and support to all the young people who are watching. Can the minister outline, for any young people who are distressed by the discourse that is currently happening around their healthcare, what services there are to support their on-going wellbeing?
I agree with Gillian Mackay entirely that it is the young people who we have to put at the centre of this, and we have to ensure that they get the support that they need. I am pleased that NHS Greater Glasgow and Clyde and Sandyford are still providing that support to young people and their families through a multidisciplinary team.
Diabetes Improvement Plan
To ask the Scottish Government what progress it is making in implementing its diabetes improvement plan. (S6O-03302)
The Scottish Government is committed to ensuring that everyone living with diabetes can access clinically appropriate, safe, effective and person-centred healthcare treatment and support. The implementation of the diabetes improvement plan is overseen by the Scottish diabetes group. Delivery is under way on work on improving diabetes education, prevention of foot ulceration, in-patient care and supporting people with diabetes during and after pregnancy. A key commitment in the plan is to increase access to diabetes technology. Since 2021, the Scottish Government has provided £19 million of additional funding to national health service boards to support that commitment.
In a letter to me last April, the minister stated:
“our aim is to improve access to closed loop and artificial pancreas systems at the earliest opportunity.”
However, patients across Edinburgh have told me that they will not get those innovative solutions because, even though they are clinically appropriate, the health board faces a severe financial situation. Even worse, a patient who was on a trial that was successful has been told that she will have to return to her glucose pump system, even though the closed-loop system has made a huge difference to her health and quality of life. Will the minister meet me and patients who are affected? Although there is a real opportunity to improve diabetes patients’ quality of life, that opportunity is not just being denied to my constituents—it is now being snatched away.
I sympathise with the situation that Sarah Boyack’s constituents find themselves in. I am happy to meet her and her constituents to hear directly about how the situation is impacting them, and to continue discussions with the clinical leads, as we do on a regular basis.
Can the minister outline how much funding the Scottish Government has invested in recent years into the provision of diabetic technologies, and what has been achieved as a result?
Between 2016 and 2022, we invested £29.6 million specifically for diabetes technologies. That was in addition to baseline funding to NHS boards. In 2023, we also invested £350,000 to pilot a national on-boarding pathway to support the roll-out across Scotland. That funding supports people—including more than 1,700 children—who live with type 1 diabetes to access life-changing technologies, such as insulin pumps.
We know that there is a lot more that we can do to increase access to diabetes technology, and we continue to work with key stakeholders to determine the best way to do that and how to fund it.
A constituent in Lothian, Stephen, was granted access to an insulin pump after a shocking three years on the waiting list, and there are reports that Lothian waiting times could increase to 10 years by the end of 2024. Waiting times in parts of England for the same technology are 14 months. Will the minister advise what action is being taken to reduce those terrible waiting times?
We are working closely with NHS boards on the way in which they choose to spend their money. I am also working closely with my officials to see what else we can do from a Government perspective.
Cancelled Operations
To ask the Scottish Government, in light of recent reports that one in 10 planned operations in the national health service were cancelled this January, what steps it is taking to reduce the rate of cancelled operations. (S6O-03303)
Surgical procedures can be cancelled for various reasons. In the year to February, 6.3 per cent of all planned procedures were cancelled for either clinical reasons or by the patient, and only 2.2 per cent were cancelled due to capacity or non-clinical reasons.
In fact, there has been a general upwards trend of operations performed since May 2020, with a 10.3 per cent increase in the year to February, compared with the previous year. Activity will further increase through our investment of £30 million to target pandemic backlogs, including in orthopaedic treatments.
The revised waiting times guidance, which was published in December, also instructs health boards to complete waiting list validation on a regular and continual basis. That ensures that waiting lists are accurate and helps to identify patients whose needs have changed, which, in turn, reduces the number of cancellations.
The message that such a level of cancelled operations is standard fare is simply not good enough. A teenager who had only months in which to undergo life-changing spinal surgery was woken after being prepared for surgery and told that the operation had been cancelled due to staff shortages.
The situation is intolerable for parents, patients and families. What action can be taken to ensure that other people who are in similar positions are treated with the urgency and respect that they deserve?
I think that the case that Alexander Stewart referred to was in NHS Lothian. He might be aware that I met both the medical director and the chair of NHS Lothian off the back of some of the coverage of the situation regarding spinal surgery there. I have also asked the chief medical officer and the chief nursing officer to intervene to look at what support could be provided to ensure that, when cancellations happen because of a capacity issue, we address those concerns.
As I said in response to Mr Stewart’s initial question, the number of procedures is going up and the number of cancellations is coming down. A recovery is under way, and we will continue to invest in it so that the situation that Mr Stewart outlined can be improved.
My constituent, Liz, unfortunately suffered a bad prolapse in 2021. She was told that, as her womb was bearing down on the prolapse, she would need a hysterectomy, the waiting list for which could see Liz wait for up to two years in pain and discomfort for her operation. What urgent action is the Scottish Government taking to reduce those long, painful hysterectomy waiting times?
I thank Foysol Choudhury for raising the issue of his constituent’s hysterectomy. If he wishes to send me further details, I would be happy to consider what more can be done in that case. I point him to the response that I gave to Alexander Stewart regarding the investments that we are making, the reduction in waits that we are seeing as a result of some of the interventions that we are making, the reduction in the number of cancelled operations and the increase in the number of operations being undertaken. If he would like to write to me with the details, I would be happy to do what I can within the limits that he would expect.
National Care Service (Headquarters)
To ask the Scottish Government what consideration it has given to the location of the headquarters of the proposed national care service. (S6O-03304)
We are currently at stage 2 of the National Care Service (Scotland) Bill and, at this point, consideration has not been given to the location of any potential premises. I set out in my letter to the convener of the Finance and Public Administration Committee in December that we anticipate that existing premises will be used, removing the need for additional cost. That aligns with Scottish Government policy on the new single Scottish estate approach and its more efficient use of existing public sector assets, which the Deputy First Minister set out in our recent budget statement and the programme for government.
As the minister will be aware, a significant amount of innovative work is under way in the Clackmannanshire part of my constituency, including the growing partnership between NHS Forth Valley, the University of Stirling and Forth Valley College, as well as the sector-leading work on sustainable ageing, which is planned as part of the Stirling and Clackmannanshire city region deal. The minister will also be aware of how central and fantastic the locations of Clackmannanshire and Stirling are.
Does the minister agree that locating the headquarters of Scotland’s national care service alongside that centre of innovation would align with its goal of future proofing the social care sector for generations to come, and will she meet me to discuss potential opportunities further?
As I mentioned in my previous answer, we have not considered the potential location of premises for the NCS. As ever, though, I am pleased to hear about innovation, and I would be very happy to learn more about the project involving NHS Forth Valley, the University of Stirling and Forth Valley College at an appropriate time.
I declare an interest as a practising national health service general practitioner. Minister, you said that we are at stage 2 of the National Care Service (Scotland) Bill, so when will we see the amendments that you have failed to produce as promised?
Please speak through the chair.
I will continue to update the lead committee. As members would expect, I have provided a response to the report from the stage 1 proceedings, and we will proceed as normal. I expect us to treat each other with courtesy and respect over this issue.
When?
As members know, this is not entirely in my control.
You are the minister.
We have to work with Parliament and other bodies to ensure that we can absolutely see through the passage of the bill, and members will hear through the lead committee.
Let us listen to both the questions and the responses with respect.
Is the minister aware that the Abbey care home in North Berwick, the Edington care provision in North Berwick and the Belhaven care provision in Dunbar are all set to close? Should the minister’s attention not be focused on the crisis in Scotland’s social care sector, not on where the Government might house bureaucrats in a £2 billion national care service bureaucracy?
As I said in my response to the original question, we have not given any consideration to the premises for the headquarters of the national care service as yet. We are simply at stage 2 of that legislation. The member points out a number of issues that are acute in the social care sector, and we are working very carefully through them with our partners in local authorities, which have the responsibility for commissioning and procuring social care at present.
Infrastructure Investment Plan
To ask the Scottish Government what discussions the health secretary has had with ministerial colleagues regarding the plans for health infrastructure investment in its revised infrastructure investment plan, including the likely publication date of any such plans. (S6O-03305)
The capital position is extremely challenging. The United Kingdom Government has not inflation proofed its capital budget, and the latest forecasts show that our block grant for capital is expected to reduce in real terms by 8.7 per cent by 2027-28, which is a cumulative loss of more than £1.3 billion. As a result of that cut, all capital projects are now under review. I expect the Deputy First Minister to set out the results of the review soon, following Cabinet consideration.
It was long before the current budget issues that he mentioned were identified, back in the spring of 2021, that plans for the new elective surgery centre at Perth Royal infirmary were announced. There was a promise that it would be completed and receiving patients by the end of this year. Three years on, an outline business case has still not been approved, the costs have spiralled and nothing seems to be happening. Will the much-needed and long-awaited facility for the people of Perthshire ever be delivered, or was that just an empty pre-election promise?
A number of projects are before me that I wish to see happen. Murdo Fraser listed one for which the case is well and truly made. However, the situation that we have is a financial reality that Murdo Fraser may not wish to hear about, which is that UK-based inflation—especially construction inflation—means that the cost of the projects has spiralled upwards thanks to uncontrolled UK inflation. Meanwhile, the UK Government does not appear to see the merit in inflation proofing its capital investment for the economy or the health service. As a result, we have a diminished capital budget, which means that we have to review our capital projects. We are committed to that undertaking, including by looking at alternative forms of finance to see as many projects as possible come about, because, like Murdo Fraser, I wish to see them happen for the improvement and recovery of our health service.
Unfortunately, the plan—when it is published—may make rather thin reading, as almost all capital projects in health have been cancelled. I want to focus also on national treatment centres and cancelled projects in Ayrshire and Arran, Lanarkshire, Lothian, Grampian and Tayside, because they were central to the Government’s plans to tackle long waiting lists. What is the cabinet secretary’s plan to deliver those projects, and when will they start?
I wish to correct Jackie Baillie’s initial assertion that capital projects in health have been cancelled. They have not been cancelled; they have been paused while the capital position is under review. The Government wishes for as many of those projects as possible to be able to get the go-ahead. I would love to be in a situation in which the UK Government saw the merit in investing in capital projects. Whether it is a Labour Government or a Conservative Government, I wish that it would see the merit of that not only for the health service but for the economy, and then we could see about ensuring that all the projects get off the ground.
The Gilbert Bain hospital, in Lerwick, is one of the oldest hospital buildings in the Highlands and Islands—as the cabinet secretary will know from his recent visit to Shetland. When will my constituents learn of the timetable for crucial work to replace the 1950s-designed building? Will we need to wait until the publication of the revised infrastructure investment plan, or can it be confirmed now that the anticipated timeline has not changed?
Beatrice Wishart is correct in saying that I was at the Gilbert Bain hospital a couple of weeks ago, when I was in Shetland. Thanks to the tour that I was given of it by Gary Robinson, the chair of NHS Shetland, and others, I am aware of the acute situation at the hospital. There are areas of it that are in a particularly bad state—I understand the issues—but I cannot give any further commitment on the timescale while the review of capital projects is under way. As per other projects that are paused at the minute, the case for it has been made and it is about raising the finance and ensuring that the project can be delivered. That is what the Deputy First Minister and me are embarking upon.
Question 7 has been withdrawn and question 8 was not lodged.
That concludes portfolio question time. There will be a brief pause before we move to the next item of business, to allow the front benches to change.