Official Report 976KB pdf
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. Members who wish to ask a supplementary question should press their request-to-speak button during the relevant question. We are tight for time across the afternoon, so I will need brevity in questions and responses in this portfolio and the next one.
Scottish Own-brand Supermarket Products
To ask the Scottish Government when it last met with supermarkets to discuss the stocking of Scottish own-brand products. (S6O-04121)
I met senior grocery retailer representatives most recently at the Royal Highland Show in June to discuss some of the good work that is being undertaken to support Scottish suppliers, as well as to look at ways of further increasing the volume of Scottish produce that is available on store shelves.
Furthermore, we have committed £10 million over the period of 2023 to 2025 to support delivery of Scotland’s food and drink strategy, “Sustaining Scotland. Supplying the World.” That funding facilitates a range of activities and direct engagement with grocery retailers to increase the volume of Scottish food and drink, including own-brand products, on retail shelves.
The cabinet secretary will be aware that NFU Scotland’s most recent shelf watch report, which was published last week, showed a decline in the stocking of Scottish-branded produce in all leading supermarkets except Lidl. That short-changing not just of our farmers and crofters but of our consumers is surely unacceptable.
What further action will the Scottish Government take, as a matter of urgency, to get the supermarkets that operate in Scotland to step up?
I thank Annabelle Ewing for raising that important point and for highlighting the important monitoring work that NFUS undertakes through its shelf watch campaign.
Of course, it is disappointing to see the outcomes in the most recent shelf watch report, but I assure Annabelle Ewing that, through the strategy that I mentioned in my initial response, we have strong engagement with all major retailers and we are doing what we can to support them to get more Scottish food and drink on to supermarket shelves.
In addition, we are doing a range of work across retail, with major retailers, smaller and local convenience stores, and the wider wholesale sector, because we want to support the stocking and sale of more local Scottish produce through Scottish suppliers.
In Scotland, we are fortunate to have one of the best natural larders in the world, and we want that produce to reach as many consumers as possible and to make it as easy as possible for them to access it. We will continue to do all that we can to enable that.
The minister will be aware that NatureScot estimates that an increase of 50,000 in the national cull of deer each year will be needed to meet the targets in the Scottish biodiversity strategy. What discussions has she or the Government had with supermarkets about bringing that abundant resource from our natural larder to the Scottish public?
Ms Villalba raises a really important point, because we want to see more of that produce on supermarket shelves. Through Forestry and Land Scotland, we have agreements with one business in particular about the deer that it can access, and that produce is available in our supermarkets. However, we want to make sure that people in Scotland can enjoy that resource and that we make it as accessible as possible to people, so we will continue to do all that we can to support that work.
Neonicotinoid Pesticides
To ask the Scottish Government whether it will provide an update on what its position is on the use of neonicotinoid pesticides. (S6O-04122)
The Scottish Government takes very seriously the potential impact on public health and the environment of the use of chemicals. We continue to support the regulatory decisions to restrict the use of neonicotinoid insecticides, due to their environmental effects, particularly on bees and pollinators. Those pesticides have not been used in Scottish crop protection since their approval was withdrawn.
Pesticide products that are authorised for use in Scotland are tightly regulated and, before authorisation, are subject to thorough analysis by the chemicals regulation division of the Health and Safety Executive, to demonstrate that the product is effective and poses no unacceptable risks to people, animals or the environment.
My constituency is the only one in the north-east of Scotland with no farms. However, Aberdeen Central has a number of beekeepers. Beekeepers are worried about the use of neonicotinoids and their effect on pollinators, and I am pleased to hear that the Scottish Government will continue to keep a tight rein on the use of those pesticides. What discussions has the minister had at the United Kingdom level to make sure that those pesticides are not used in these islands?
Whether those pesticides are used in these islands is a matter for the UK Government—the Scottish Government can do only what we are doing here.
We operate a range of monitoring strategies in Scotland. Pesticide usage patterns are monitored by our pesticide usage team, which performs annual surveys to estimate Scottish pesticide use on a range of agricultural and horticultural crops, and a lot more besides. I am more than happy to meet the member if he wants to know more.
Will the minister update the Parliament on progress to find a replacement for Asulox in the control of bracken?
As the member knows, a number of issues are being looked at around the control of bracken, and we can provide an update on that as we come to a conclusion.
International Fishing Vessels (Monitoring)
To ask the Scottish Government how its marine directorate monitors international fishing vessels. (S6O-04123)
The marine directorate monitors fishing activities by using its network of coast-based officers, marine protection vessels, surveillance aircraft and a 24-hour monitoring centre. Inspections on all vessels are determined using either a risk assessment process, which considers fleet types and impacts but not nationality, or assurance inspections.
The monitoring of vessel landings involves ascertaining the quantities and species by counting and observing any weighing of fish and checking the results against mandatory pre-landing electronic documentation. Additionally, post-landing checks are undertaken, focusing on vessels that do not land into a Scottish port. Those require collaboration with inspection agencies from the landing or flag states.
I want to see a thriving fishing sector that makes the most of all opportunities. However, there is a part of the industry that is concerned that some landings are not correctly recorded. It is vital for our fleet that our data is fully robust and that there is equality in monitoring.
One of the concerns relates to when European Union boats return to land in their own European ports. Last year, Scottish and United Kingdom authorities negotiated with the Faroese Government for Faroese vessels that are exiting UK waters, and vice versa, to make their way to a predetermined point for inspection before exiting the exclusive economic zone. Has the cabinet secretary, working with the UK and Scottish authorities, contemplated putting in place similar plans for EU vessels that are leaving UK waters to land their catch elsewhere, which might help to establish some control in that area?
Tim Eagle raises really important points, and I absolutely agree with him about wanting to see a thriving fishing sector. The control areas that he mentioned are currently part of the agreement that we have with the Faroese demersal and mackerel fisheries, as well as a Norwegian mackerel agreement. They have worked particularly well in the recent mackerel fishery, because vessels were directed to a control area where they were inspected by either a marine protection vessel or by coastal officers in port.
However, the control areas are resource intensive, which can limit the availability of the assets that we have to inspect vessels while they are fishing. Marine directorate officials regularly use powers to require a vessel to move to an area to facilitate an inspection, and all non-UK vessels that are departing UK waters must electronically submit the time that they want to exit, as well as the quantity of fish that they have on board. That allows for the targeting of vessels prior to their exiting UK waters.
The control areas have worked well and we continue to look at how we can improve them, but we need to take into account the resource considerations.
A freedom of information response in August showed that, out of 81 marine directorate job posts advertised, only 27 were filled. I have previously raised concerns with the cabinet secretary about the state of the organisation’s laboratory building in Aberdeen. Does the cabinet secretary agree that, without a fully staffed team and adequate resources, the marine directorate will struggle to fulfil its remit, including the appropriate monitoring of landings by non-UK fishing vessels?
The marine directorate covers a wide area, so I would have to look into the job vacancies that the member mentions in a bit more detail.
The member rightly mentions the marine lab in Aberdeen, which we have discussed at length in committee. I recognise how important those facilities are and the need to keep them in good order. A Scottish Government project is under way to look at the overall long-term plans for the site, and the matter is still under consideration. However, we want to upgrade the facilities as best we can to provide a good working environment for the staff of the marine directorate.
Farming Businesses (Support for Diversification)
To ask the Scottish Government what action it is taking to support farming businesses that are seeking to diversify. (S6O-04124)
The Scottish Government strongly supports farming businesses to diversify, providing businesses with a range of income streams and stimulating the rural economy.
We provide support to plant and manage trees, and provide advice, events and courses on business resilience and diversification through the Farm Advisory Service and Skills Hub Scotland. We give funding to Scottish Agritourism to assist agritourism businesses that keep multiple generations of farming families in employment in rural areas, which is really important, and provide support to help businesses to promote and sell their produce locally and regionally.
Unfortunately, United Kingdom Government budget decisions are having a really damaging impact on our ability to fund measures on the multiyear horizon that agriculture needs.
Annually, farms that have diversified bring millions of pounds to Scotland’s economy, and the services that they offer can include farm shops, garden centres, milk vending machines, coffee shops and camping pods. However, their rural location means that infrastructure and signage is key to allowing customers to find them. Businesses face major barriers in obtaining signage for opening up and directional signage when improvements are made to main roads.
The Coo Shed in my local area received no prior communication that its main access road was to close for four months. The closure impacted customers, farm suppliers, milk tankers and the company’s sales, causing unnecessary stress and anguish. What discussions can the minister have with his colleagues in other portfolios to make major improvements to that process?
That is a really important question, and I take it in the spirit in which it was asked. As far as signage is concerned, that is a transport issue, and I will take that away.
As far as access to a local business is concerned, I am more than happy to meet Sharon Dowey to discuss that specific issue.
Connectivity is part of my portfolio, so I will follow up on the specific issues of signage and what we can do to help with that.
Scottish Food Industry (Promotion)
To ask the Scottish Government what it is doing to promote the Scottish food industry. (S6O-04125)
Scottish Government funding towards the food and drink industry strategy, “Sustaining Scotland. Supplying the World”, supports a range of measures to promote Scottish produce at home and internationally, showcasing our remarkable food and drink businesses to wider audiences and markets.
A key example of that is the Showcasing Scotland global sales event that was held in March in Edinburgh, which connected more than 100 top international buyers with more than 100 Scottish businesses, potentially generating £77 million in sales for Scottish food and drink producers.
In a recent joint statement, the Scottish Pelagic Processors Association and the Scottish Seafood Association said that the Labour United Kingdom Government’s increase to national insurance contributions could threaten the seafood industry in Scotland. What discussions has the cabinet secretary had with the UK Government about the impact that that could have on Scotland’s food industry?
Marie McNair raises a hugely important point. It is fair to say that food and drink businesses and our third sector—indeed, everyone across the piece—are struggling with the impact of the decisions that the UK Government has taken in its budget.
Marie McNair will be aware that the Scottish Parliament, in a number of debates that were held in November, has called on the UK Government to urgently commit to undertake and publish impact assessments on its budget announcements.
However, I want to highlight to Marie McNair and more generally to members from other parties that, together with the Cabinet Secretary for Finance and Local Government, Shona Robison, we have written to the UK Treasury to outline our serious concerns about some of the proposals in and the far-reaching impacts of the UK Government’s budget.
Scottish ministers will continue to make those representations to the UK Government. We have regular ministerial meetings through the interministerial group, where we will continue to raise those matters.
Question 6 was not lodged.
Family Farms (Inheritance Tax Liability)
To ask the Scottish Government, regarding the potential impact on agriculture, what assessment it has made of the number of family farms in Scotland that will incur inheritance tax liability as a result of changes announced in the United Kingdom budget. (S6O-04127)
I thank Stephen Kerr very much for raising this issue again.
Our officials have met representatives of the farming sector and UK Government officials to determine the impact of the policy change on family farms in Scotland. Given the lack of available data on the impact of the decision, there must be an immediate reversal and review of the policy. That should be followed by close engagement with the agricultural sector and the devolved Parliaments, so that there can be a proper understanding of what the policy will do to family farms.
Early estimates suggest that around 5,000 farm businesses in Scotland are likely to be worth more than £1 million and will potentially be impacted by the change. Due to the limitations of data on tenancies, we are unable to provide a separate estimate at this time of the number of tenant farmers who will be affected by it.
I have done a calculation based on the UK Government’s assessment that, overall, 28 per cent of farms will be impacted by its family farm tax grab, which means that, potentially, around 12,000 family farm businesses will be impacted.
Labour’s family farm tax will have a devastating effect on the future of family farms and crofts. Scottish Land & Estates said that the
“effect of these measures threatens the immediate viability and future sustainability of thousands of rural businesses across Scotland.”
On top of Labour’s blow, the Scottish National Party budget was a bitter disappointment. The SNP is accused by the sector’s representative bodies of failing to back rural Scotland, cutting funding in real terms—
Please come to the question.
—and failing to treat rural Scotland with seriousness. How does the minister expect the sector, given the challenges that it now faces, to remain attractive for the next generation of farmers, especially given—
I call the minister.
—the dearth of new entrants? What specific steps will the Scottish—
Minister.
Stephen Kerr’s first point highlights the fact that there are many different proposals for how to analyse what is happening in the family farming sector. The UK Government has to reverse its decision in order to do a proper impact assessment that will allow us to know exactly what is happening in the Scottish sector.
On Stephen Kerr’s second point, the Scottish Government has maintained the full level of funding that has come from the UK Government, but it was his party’s Government that ceased to increase the level of that funding. His Government took us out of the European Union, which had given us multiyear funding that was guaranteed for seven years. His Government did all of that, yet he has the audacity to come to this chamber and criticise the Scottish Government.
We have a couple of brief supplementary questions.
To build on that response, does the minister agree that the uncertainties that the proposed inheritance tax change have brought about come in addition to the damage that has been caused by other policy decisions that have been taken by the current and previous UK Governments, including reckless trade deals that undercut our Scottish farmers?
Yes, I agree with everything that Emma Harper has said. The Scottish industry is vital to rural Scotland. The Scottish Government has always put its full weight and support behind the industry, and we will continue to do so.
I am against the inheritance tax changes for the agricultural sector, which will have a devastating impact and are not good for farming. However, the minister cannot simply say that the UK Government has to reverse the policy, although I agree that it should be reversed; he has to have a much more practical plan for dealing with its consequences. If he does not understand what those consequences are, what hope does the farming sector have in looking to the Scottish Government to come up with answers? For instance, what will the policy change do to its land reform proposals? What will change on that front if those measures go through?
Willie Rennie has gone about five steps forward there. He accepts that the decision must be reversed until there is a full assessment. There is a policy objective—perhaps not a bad one—behind what the Labour Party has done. However, it has completely misunderstood family farming in Scotland, the thresholds to which we have to work and the effects that the decision will have.
For the Labour Party to ask us to find solutions to that is a little bit off. Let us get the UK Government to sort the mess out in the first place, and we can start working forward from there.
Tenant Farmers (Impact of Agricultural Property Relief Changes)
To ask the Scottish Government what assessment it has made of any specific impact on tenant farmers in Scotland of the announced changes to agricultural property relief on inheritance tax. (S6O-04128)
Over half of Scottish agricultural tenancies are secure heritable tenancies. They are a unique feature of Scotland and might be disproportionately affected by the inheritance tax change compared with other parts of United Kingdom agriculture. Scottish Government officials are due to meet His Majesty’s Revenue and Customs officials to discuss the impact of the changes on that particular group. The Scottish tenant farming advisory forum has written to the Treasury and the Secretary of State for Scotland to highlight the issue.
I believe that inheritance tax powers should be devolved to the Scottish Parliament so that the tax decisions can be designed and tailored in a Scottish context. As the cabinet secretary said, along with the Cabinet Secretary for Finance and Local Government, she has written to the UK Government to ask it to stop this damaging process.
As we know, we are talking about family farms that have been worked through the generations. It is not an ordinary job or business; it is a way of life. Many of those families will now be worried sick as to whether they can continue to the next generation. Does the minister agree that the irony is that, if the farms are taken over by individuals not to farm but to reduce their inheritance tax liability—to do a Jeremy Clarkson, if you like—that would help rich hobby farmers to the cost of real farmers? Does Sir Keir Starmer understand rural Scotland at all?
The straight answer to that is no. The Scottish Government shares the concerns about the potential impact of the imposed tax changes, and it is committed to working closely with our partners to fully understand the implications. Officials are already working with tenant farming stakeholders and the Scottish Land Commission to start to assess the range of impacts from the imposed tax changes. The Scottish Government has been clear with the UK Government about the concerns, and we will continue to emphasise them. A meeting with HMRC is scheduled to go ahead this week to gain further clarity on the potential effect on tenant farmers.
That concludes portfolio questions on rural affairs. I note that the member who asked question 2 subsequently left during portfolio questions. I am very disappointed to see that. I will expect both an explanation and an apology.
There will be a brief pause before we move to the next item of business, to allow members on the front benches to change.
Health and Social Care
The next item of business is portfolio questions on health and social care. Members who wish to ask a supplementary question should press their request-to-speak buttons during the relevant question.
Heart Disease Treatment Waiting Times
To ask the Scottish Government what action it is taking in light of statistics reportedly showing that a record number of people have been waiting over a year for heart disease treatment. (S6O-04129)
We remain determined to drive down waiting times. Our proposed budget, which was set out on 4 December, allocates almost £200 million to reduce waiting lists and support the reduction of delayed discharge. By March 2026, we expect no one to be waiting longer than 12 months for a new treatment. Our heart disease action plan seeks to ensure that everybody with a suspected heart disease issue has timely and equitable access to diagnosis, treatment and care in Scotland. Progress to date includes supporting the effective use of data to drive improvements and the development of nationally agreed pathways of care.
In June, the cross-party group on heart and circulatory diseases published a report on its inquiry into the heart disease action plan. Clinicians reported that encouraging work is going on across Scotland to innovate and improve services, but the ability to implement that across all health boards is suffering due to a lack of funding. Will the cabinet secretary commit to increasing the focus on investment and the contribution to dealing with conditions across Scotland, because heart disease is Scotland’s single biggest killer?
Initial funding of £2.2 million over five years was provided to support the heart disease action plan from 2021, and we have committed to enabling a transformational shift in the use of cardiac data. That is why we commissioned the Scottish cardiac audit programme, in which we are investing £1.5 million over five years. In addition, the chief medical officer, Sir Gregor Smith, currently chairs the newly established cardiovascular disease risk factors programme, which is about preventing people from contracting a cardiovascular disease in the first place. That programme seeks to improve public and community understanding and to transform the models of care for the identification and management of the risk factor conditions. I hope that that helps to alleviate the concerns that Alexander Stewart might have.
Although the issue that Alexander Stewart raises is of particular concern to Scotland, long waits for any patients are unacceptable, and urgent action must be taken to reduce waiting times across our national health service. Can the cabinet secretary say anything about the work that the Scottish Government is undertaking to help boards across the country to provide additional procedures and extra appointments?
Yes, I can. I appreciate Joe FitzPatrick’s interest in the issue. All long waits are regrettable, and I apologise to any patient who has had to wait too long for treatment and, indeed, to any clinician who has had to explain that long wait to their patients.
We are working hard to drive down waiting times. This year, our £30 million additional investment will deliver around 12,000 new out-patient appointments, 12,000 in-patient procedures, and more than 40,000 diagnostic procedures. As part of the 2025-26 budget announcement, we are allocating £200 million to help clear long waits and improve capacity, which will drive vital progress. The funding will be targeted at specialties with the longest waits and will ensure that, by March 2026, no patient will wait longer than 12 months for a new out-patient appointment or in-patient or day-case procedure.
The NHS is stretched to breaking point, and the Scottish Government’s promises to bring down waiting lists, including those for heart disease treatment, lie in tatters.
Targets to remove long waits of more than a year were supposed to be met by September 2024, but the Scottish Government has failed to meet them. In England, 113 people are waiting more than two years; in Scotland, more than 11,000 people are waiting the same length of time. In per capita terms, Scottish waiting lists are 1,000 times longer. Does the cabinet secretary want to apologise to the people of Scotland for the SNP’s failure?
I already said, in response to Joe FitzPatrick’s question, that I apologise to anybody who is waiting too long for treatment and, indeed, to any clinician who is having to explain those long waits. Of course I apologise.
That is why there is the investment that we are taking forward through the budget, which I would encourage Jackie Baillie to support, because she recognises the need for us to drive down long waits. However, she cannot will the end without willing the means, so the Labour Party needs to support the budget to ensure that the funding gets put in place so that we can get those waiting times down.
Mental Health Services (Children and Young People)
To ask the Scottish Government whether it will provide an update on how it is working to improve access for children and young people to mental health services. (S6O-04130)
The Scottish Government is committed to ensuring that everyone has access to mental health support when they need it. We have supported increased mental health spending and seen the best ever reporting in national performance against the 18-week child and adolescent mental health service waiting time standard since it was introduced in 2014.
In addition, we have provided councils with more than £65 million since 2020 to develop and fund community-based supports for children and young people. Nearly 83,000 children, young people and family members accessed those early intervention and prevention services between July 2023 and March 2024.
We also provide £16 million a year to local authorities to ensure that children and young people have access to counselling through every secondary school in Scotland.
Will the minister outline how the Scottish Government will continue to invest in our local authorities and health boards to ensure that young people have quick access to the support that they need when they need it?
We have allocated £120 million to national health service boards and integration joint boards to provide a single flexible funding stream, supporting continued improvement and better outcomes across mental health services, including CAMHS.
As I explained, as part of our effort to embed early intervention and prevention, our £15 million per annum investment in community-based mental health and wellbeing support and services for five to 24-year-olds and their families will be baselined in local authority budgets from 2025-26. More than 300 services are now available across Scotland. We will also continue to ensure access to school counselling services, which benefited more than 14,000 pupils in the first half of 2023 alone.
There is a lot of interest in this question. I will get through as many supplementaries as I can, but they will need to be brief.
Some of the CAMHS waiting lists now sit at five years, so we really need to support the third sector. Two local third sector mental health organisations in my area are in danger of closing because of a lack of funding from the local council. Is it not the issue that the third sector is generally financed through the local council, whereas statutory services are financed through the NHS? How can the Scottish Government ensure that those vital third sector organisations are properly funded, and that more pressure is not heaped on statutory services?
First, let me be absolutely clear that, in the last quarter of this year—up to September this year—we have seen the best ever performance for CAMHS that has been reported since the 18-week standard was introduced in 2014.
There are challenges with neurodevelopmental assessments: we do not collect sufficient data on those and we need to improve that. However, let us be clear that, although the CAMHS situation has been very difficult for a long number of years, the service is now very close to target—it is less than 1 per cent off.
I absolutely agree on community services. We have invested an extra £1 billion in local authority budgets this year, which will have an impact on those services. As I set out in my first answer, we have specific funds to improve mental health and wellbeing for children and adults in our communities. I will ensure that those are continued.
Is it not the case that the Government has never met its target of 90 per cent of children being seen by CAMHS within 18 weeks and that, in the past quarter, almost 30 per cent of CAMHS referrals were rejected? How is the Government meant to deal with that positively when it has cut the mental health budget by 1 per cent in real terms and there has been a cash cut of £20 million year to year?
Answer as briefly as possible, minister.
There are a few things to correct in that question—I apologise, Presiding Officer.
We have not cut the budget. The draft 2025-26 budget increases the direct programme for mental health by 1.2 per cent to £270.5 million. In the past five years, the direct programme budget for mental health from 2021 to 2026 has more than doubled. Let me be absolutely clear that we continue to invest in mental health.
CAMHS performance is outstanding. It is at 89.1 per cent of children being seen within 18 weeks. In September, we met, and exceeded, the target. I fully expect us to attain it and then the work will be on to maintain it and make further improvements across the board in mental health.
I apologise to members whom I was not able to call.
NHS Grampian Bed Capacity
To ask the Scottish Government how it is supporting NHS Grampian to increase bed capacity, particularly in light of increased demand during the winter period. (S6O-04131)
I appreciate the interest that Jackie Dunbar and other constituency members have shown in the issue and the involvement that they have had in it.
My officials and I have met regularly with the leadership of NHS Grampian to progress immediate steps and a sustainable plan to ease capacity pressures, with a focus on improving patient flow through the system, preventing ambulance turnaround delays and discharging patients as soon as they are medically fit.
We continue to support and monitor all health boards to ensure that all possible actions are taken to support services and safeguard patient safety during the winter period. Planning for this winter builds on the effective measures that have supported our health and social care services in previous years.
I understand that, in colder months, additional strain and pressure on bed capacity are added to our healthcare services due to folk not being familiar with where they should access the most appropriate care in their individual circumstances. How is the Scottish Government working to ensure that folk receive the right care in the right place at the right time this winter?
Jackie Dunbar’s question is timely. That issue was part of the visit that I carried out to the Scottish Ambulance Service in Edinburgh this morning, ostensibly to thank staff for their incredible work and the sacrifice that they make at this time of year but also to demonstrate the clear pathways that are available to patients over the winter, when we all understand the pressures that there are across the system.
To ensure that people know where to seek urgent care this winter, we relaunched the right care, right place campaign this October. The campaign has been designed to communicate the appropriate use of urgent care services, specifically accident and emergency, in an effort to help to reduce the pressures that are felt across the system. The clear messages are that, for advice on minor illnesses and injuries, people should visit nhsinform.scot and that by checking the NHS inform symptom checker, people can easily get the health information that they need to safely treat their symptoms at home. Also, people should call their general practice or NHS 24 on 111 for urgent but non-life-threatening health conditions and always to call 999 in an emergency.
Last week, Aberdeenshire health and social care partnership emphasised that
“there has been no funding from Scottish Government to support initiatives to manage seasonal pressures”.
Crucially, it added:
“As such, there are limited additional levers that can be introduced to manage surges in demand at this time”.
Given that NHS Grampian is already at crisis point, how can the Scottish National Party Government seriously expect community health and social care services to tackle rising demand when they have not been given the resources to address it?
The funding of our health and social care partnerships is not just for the Government to consider. It involves local decisions that are taken by health boards and local authorities.
However, I encourage all health and social care partnerships that have a plan for increasing capacity and that wish to have greater support to come forward: our door is open to those considerations and discussions, just as it is to the discussions that are on-going with NHS Grampian on a sustainable model to respond to the critical incident that happened.
I encourage the continuation of our weekly engagement through the charging for residential accommodation guidance, so that if there are any areas of concern across the country, they can be addressed at either a local or national level.
I will need a bit more brevity, in the responses in particular but also in the questions.
General Practitioner Provision (Franchising)
To ask the Scottish Government what action it is taking to prevent the emergence of a franchise model of GP provision. (S6O-04132)
The Scottish Government believes that the independent contractor model is the profession’s preferred one, and is committed to maintaining that model to ensure that general practice remains an attractive profession.
The GP contract regulations require all GP practice partners to be sufficiently engaged in providing primary medical services in Scotland. The Government recently consulted the profession on whether the contract regulations are appropriate, and we are now analysing the consultation results.
I thank the cabinet secretary for that answer. However, some GP partners are clearly abusing the system by putting themselves forward in multiple practices, not seeing patients, not being involved in patient care and certainly not being present on site. There is one such example in my constituency, in Upper Nithsdale. I have raised the issue with the health board, and the health board pointed back to the contract. However, I do not think that the contract is sufficiently robust to ensure that patients are safe.
I appreciate Oliver Mundell raising the issue. Obviously, it is primarily a matter for the health board to deal with. However, if he has evidence of such a situation—or if any other colleagues do—I would be more than interested to see that evidence and to see what can be done to address the situation.
I welcome the cabinet secretary’s remarks on franchising. However, alarmingly, many primary care providers, including GPs, have cited concerns about the sustainability of their practice models following the harsh announcement from Labour’s Westminster colleagues that employer national insurance contributions will be increased. What steps is the Scottish Government taking to protect and increase primary care provision across Scotland in the light of that United Kingdom Government policy, which, in essence, will cut public funding by the back door?
That question is not strictly related to franchise models, but I will call the cabinet secretary.
The sustainability of general practices and primary care service delivery is of grave concern to me and to colleagues in the British Medical Association. Iain Morrison, the chair of the Scottish general practitioners committee, has described the national insurance rise as “potentially a substantial blow” that could lead to patients suffering. We estimate that the increase might cost between £520 million and £580 million for directly employed public sector employees, and a further £210 million for those who are contracted to deliver services from the third sector. That is a significant issue of grave concern, and the UK Government must resolve the problem that it has created.
An Audit Scotland report on whether the 2018 general medical services contract has been working effectively is due to be published in April 2025. Recent workforce statistics have shown that there has been an increase in the GP to patient ratio—currently, there is one GP for every 1,743 patients. Can the Government offer the public and doctors any reassurance that the worsening problem is being addressed?
We remain committed to increasing the number of GPs in Scotland. GP headcount is consistently more than 5,000, and the number of GPs has increased by 307 since 2017.
However, I recognise that there is an issue. We are taking forward the GP attraction and retention plan, which has been welcomed by the Royal College of General Practitioners and the BMA, because we recognise that the record 1,200 GPs who are in training need to come into practice in Scotland, so that we can address Carol Mochan’s concerns. I am absolutely focused on delivering that.
Burghead and Hopeman Nurse-led Service Pilot Proposal
To ask the Scottish Government what consideration it has given to the proposal from save our surgeries in Burghead and Hopeman to pilot a nurse-led service in the villages following the closure of their general practitioner surgeries. (S6O-04133)
The Scottish Government has carefully considered the save our surgeries group proposal, but, unfortunately, it is not in a position to fund a pilot nurse-led service in the villages.
We recently announced the investment of £13.6 million of immediate stabilisation money in general practice. That money will support all GP practices to withstand cost pressures that are being faced now and will be faced in the future, but it means that there is no resource for pilot projects.
The Scottish Government would encourage NHS Grampian and Moray health and social care partnership to ensure that the needs of patients are met following the closure of their GP surgeries.
I have to say that that is a disappointing response from the minister. Health and Social Care Moray considered the pilot last week and said that it could look at it further, but only if the Scottish Government provided ring-fenced funding for it. I ask the minister to consider it again. Can she tell members what value she has put on the pilot? If she has ruled it out, I presume that she must know how much it was going to cost.
I thank Douglas Ross for his question and recognise the work that he has done to support the communities. Officials are also working on guidance on branch closures for boards and integration joint boards. Stakeholders will be consulted in the new year.
We are also considering whether best practice guidance can be developed on exploring community-led solutions when delivery plans or estate strategies result in the withdrawal of services for owned or leased buildings. That is something that I am aware of. As I said in my response to Mr Ross’s initial question, money has been diverted into other areas, which, unfortunately, does not allow us to put any funding into the pilot this year.
Question 6 is from Michelle Thomson, who is joining us remotely.
Psychological Support for People with Long-Term Conditions
To ask the Scottish Government how its increased funding for mental health services will help improve access to psychological support for people with long-term conditions, such as inflammatory bowel disease. (S6O-04134)
Mental health is an absolute priority for the Government. Even in the context of the past few difficult financial years, we have continued to invest wisely. We have record numbers of staff providing more varied mental health support and services to a larger number of people than ever before, including psychological support for people with long-term conditions such as inflammatory bowel disease.
The majority of spending on mental health is delivered through NHS board budgets. We expect NHS boards to deliver healthcare services that are safe and effective and that put people at the centre of their care.
The minister might be aware that, last week, IBD UK launched a new report on care for people with Crohn’s disease and colitis across Scotland. The report highlights that, despite the severe impact that such conditions can have on a person’s mental health, none of the 18 adult IBD services in Scotland that responded met the IBD standards for multidisciplinary team staffing, and there was a lack of adequate provision for psychologists across all the services. Indeed, four in five patients reported not being asked about their mental health needs.
What consideration has the Scottish Government been able to give thus far to the concerns raised in the IBD UK report, including about the growing mental health need among people with long-term health conditions?
The Scottish Government welcomes the recently published report by IBD UK. We will consider the report’s findings carefully to ensure that all people in Scotland who are living with IBD are able to access the best possible care.
Our mental health and wellbeing strategy lays out our approach to ensuring that anyone can get the right support for their mental health, including people whose mental health has been affected by an inflammatory bowel condition. We published the national specification for psychological therapies and interventions in September 2023, setting out the standards to which we expect psychological therapies and interventions to be delivered, which include appropriate staffing.
More than 50,000 people in Scotland live with Crohn’s disease and ulcerative colitis—Scotland has the highest prevalence of any country in the UK. I know that the minister is aware of that, because she attended one of our events last year.
The existence of IBD nurses has transformed the experiences of patients such as Maretta, who spoke to the group. She lost her IBD nurse in her local service, but it is a life-saving specialism. Is the minister willing to meet me and others to discuss the IBD nurse service? The specialist service has fundamentally changed people’s health experiences, and we need to ensure that that is covered across Scotland.
As briefly as possible, minister.
I would be more than happy to commit to that. It might lie in my colleague Jenny Minto’s portfolio, but I would be more than happy to commit her time to that endeavour.
Easily done.
National Health Service Funding
To ask the Scottish Government what the expected health outcomes will be of the proposed increase in funding for Scotland’s NHS, as announced in the recent 2025-26 budget statement. (S6O-04135)
The recent 2025-26 budget statement proposes a record £21.7 billion in funding for health and social care in Scotland, which will help patients to get appointments quicker and receive treatment sooner. Our investment aims to improve the patient experience, ensuring that the journey from diagnosis to treatment and then to aftercare is as straightforward and stress-free as possible. We have also committed to providing £200 million to reduce waiting times and improve capacity in order to make the system more efficient and reduce delayed discharges. As a result, we expect an extra 150,000 patients to be treated by March 2026.
Thank you, cabinet secretary. I welcome, in particular, the fact that my constituents will benefit from an uplift in direct investment in NHS Greater Glasgow and Clyde amounting to almost £400 million. Will the cabinet secretary join me in encouraging my fellow MSPs on the Opposition benches to support the Government’s 2025-26 budget and ensure that constituents across Scotland see the benefit of the highest-ever funding for Scotland’s NHS since devolution?
Yes, I will. In my answer to Jackie Baillie, I made that exact point. We recognise that the budget is about addressing issues in the health service. The health service needs the budget to pass. The Opposition parties in this Parliament cannot just will the end; they must will the means as well.
The budget includes an investment of more than £16.2 billion in our health boards, representing a 3 per cent cash uplift, which is a real-terms increase in baseline funding to support vital front-line services. It also includes £139 million of additional investment across NHS infrastructure to support improvement and renewal. It is a budget by Scotland for Scotland that focuses on delivering progress and lays the foundations for Scotland’s long-term success. I encourage all MSPs across the chamber to support it.
National Health Service Dentist Registrations
To ask the Scottish Government what it is doing to increase active patient registrations with NHS dentists. (S6O-04136)
The primary aim of dental payment reform that was introduced in November 2023 is to improve access by incentivising dentists to remain in the NHS and thereby provide longer-term sustainability to the dental sector. Through payment reform, the Scottish Government has made a meaningful whole-scale intervention for the sector and has introduced a realistic package of fees that better reflects the costs of delivering modern primary care dentistry.
The latest official statistics show that, between the introduction of reform and the end of September 2024, almost 4 million courses of treatment had been delivered to patients.
In Fife, some 84 per cent of the population are registered with NHS services, but that does not equate to access to dentistry. Only 63 per cent of those who are registered have seen a dentist in the past two years, which means that close to half the people in Fife are not registered with an NHS dentist or have not seen an NHS dentist over that period. Almost 41,500 people in Fife are not registered with an NHS dentist, and more than 9,000 of those are children. In addition, no dentists in Fife are registering new patients. Although four practices are running a waiting list, they expect people to have to wait for more than a year.
I understand that Fife, Dunfermline, Glenrothes and Kirkcaldy have been included in the Scottish dental access initiative, but what else is the Government doing? When will we see progress being made in Fife to allow people to access NHS dentistry?
I recognise the issues that Claire Baker has raised, which we are addressing. We are working very closely with NHS Fife to ensure that it—alongside independent dentists—can provide the appropriate service.
For example, there has been an increase in the public service dental workforce, and the health board has provided a phone line. Further to that, I am working closely with colleagues across the United Kingdom, including the Minister of State for Care, Stephen Kinnock, to ensure that we can increase the number of dentists who come to the UK to provide the important services that we need.
I refer members to my entry in the register of members’ interests: I hold a bank nurse contract with NHS Greater Glasgow and Clyde.
I welcome the fact that the level of registration is significantly higher in Scotland than it is in the rest of the UK, with more than 95 per cent of Scotland’s population being registered with an NHS dentist. However, I recognise that the problem of the recruitment and retention of dentists poses a threat to accessibility to services for registered patients. What steps is the Scottish Government taking to overcome that issue, particularly in areas where the problem is most acute?
Please be very brief, minister.
I will be.
The initiatives that are under consideration include increased multidisciplinary working in dental practice to make better use of all our workforce. In addition, as I indicated, we are doing cross-UK work to improve the number of international dentists.
I apologise to those members I was unable to call. We have gone a little over time, but we are pressed for time across the afternoon.
That ends portfolio question time. There will be a brief pause before we move on to the next item of business, to allow front-bench members to change places.
Air adhart
Education (Scotland) Bill: Stage 1