Rural Affairs, Land Reform and Islands
Good afternoon, colleagues. The first item of business this afternoon is portfolio question time. The first portfolio is rural affairs, land reform and islands. I invite members who wish to ask a supplementary question to press their request-to-speak button during the relevant question. There is quite a bit of interest across both portfolios, so I appeal for brevity in questions and responses.
Woodland Planting Targets
To ask the Scottish Government how the spending proposals in its draft budget will help to achieve woodland planting targets. (S6O-02990)
The draft budget will support more than 9,000 hectares of new woodland creation in Scotland, which will be more than in the rest of the United Kingdom combined. We are engaging with stakeholders so that we can maximise tree planting and its benefits to the climate, the economy, people and nature.
I thank the minister for that answer, but she neglected to say that the Scottish Government’s target is to plant 18,000 hectares of trees per year. It is now providing funding for half of that, so the answer to the question is that the draft budget will not help to achieve the woodland planting targets—that was the answer that the minister was searching for.
If Scottish Forestry’s woodland grants budget is going to remain lower after 2024-25, which it will, how will resources be split between native woodland creation, commercial forestation, agroforestry and trees outside woods, given that there is not enough money to fund more than 9,000 hectares of planting?
I am glad that Graham Simpson has given me the opportunity to respond to what he said about the 18,000 hectare target. There was, of course, that target, and we do not want to be in this situation, but the UK Government has reduced the Scottish Government’s capital allocation by 10 per cent. I do not know how good Mr Simpson’s arithmetic is, but when funding is slashed to the bone, as it has been—the autumn statement was as disappointing from the Scottish Government’s perspective as this situation is—devolved Governments need to make very difficult decisions about what they spend their budgets on.
It seems to me that, on many occasions, the Tories are content to shout about targets—they even vote for the setting of targets from time to time—but when it comes to advocating for the UK Government to uphold its responsibility to allocate adequate funds to devolved nations to allow us to fulfil our obligations, they are completely silent.
I do not have the details of—
Thank you, minister.
Scotland is creating the most woodland in the UK, and it will continue to do so, despite the Tories savaging our budget by cutting our capital allocation. Does the minister share my view that, if that is what we can hope to achieve in the current fiscal nightmare, there would be no limit to what the forestry sector could achieve if the Scottish Tories put Scotland first and took a stand against the 10 per cent cut to our budget?
I agree with Emma Harper that it is a “fiscal nightmare”. For many years, we have worked closely with forestry stakeholders to increase confidence and to grow capacity to deliver woodland creation in Scotland. As a result, during 2023, record levels of woodland creation projects were in development—schemes for both native and productive conifer—and we are encouraging applicants to turn that development into successful planting, so that we utilise all of our available budget this year. That would put us back on track for 2023 to be a record year, but the potential for 2024 is greater. Unfortunately, as Emma Harper pointed out, the reduced funding from the Westminster Tory Government means that the situation will be challenging.
King’s and Lord Treasurer’s Remembrancer (Powers)
To ask the Scottish Government whether there is any scope in its proposed land reform legislation to amend the power of the King’s and Lord Treasurer’s Remembrancer, known as the KLTR. (S6O-02991)
The King’s and Lord Treasurer’s Remembrancer is the Crown’s representative in Scotland with the authority to deal with ownerless property. Any surplus funding from the KLTR’s responsibilities is passed to the Scottish Government as a contribution to the Scottish consolidated fund. The KLTR’s powers derive from Scots common law and do not involve the exercise of executive power or control by the King. Given the KLTR’s previous, current and future contributions to the Scottish public purse and the role’s clear alignment with Government priorities, there are no plans to amend the KLTR’s current powers in the proposed land reform bill.
I thank the minister for that explanation. I am pleased that any moneys that are released from such assets go to support essential public services. However, does the minister agree that often communities can be blighted by derelict and vacant land and assets that would fall to the KLTR? How can we ensure that communities might also benefit from such assets and their value in the future?
I thank Rona Mackay for that supplementary question and for her continued interest in vacant and derelict land.
In addition to the annual contribution to public funds, the KLTR is about to launch the ownerless property transfer scheme. I can confirm today that the date for the launch is 1 March 2024. The scheme will create new opportunities for public bodies, local authorities and community organisations across Scotland to acquire ownerless property, and it will help them to return local land and buildings, including abandoned and neglected property, to productive use for the benefit of local communities. It has been carefully designed with key stakeholders to ensure that properties are used and developed sustainably and in the public interest.
Fishing Suspension (Firth of Clyde)
To ask the Scottish Government whether fishing in the Firth of Clyde will be suspended in 2024, in line with the cod spawning season. (S6O-02992)
Following consideration of the Firth of Clyde closure, which was implemented for 2022 and 2023, and the responses to the public consultation that was carried out between June and September last year, I consider it appropriate to continue the spawning closure in the same manner, without exemptions, for the 2024 and 2025 period. That decision is based on the best available scientific evidence, which shows that any activity within 10m of the sea bed has the potential to impact on cod spawning activity.
When will a full business and regulatory impact assessment be published? I know that the minister said that she would not consider exemptions, but will she consider exemptions for nephrops trawlers, creels and scallop dredgers?
We are working hard with the available data that we have on the Clyde to make decisions on the matter. We are under no illusion that a 10-week closure of particular areas of the Firth of Clyde is inconvenient and could be potentially costly for some vessels. However, those vessels can fish in other parts of the Clyde in that 10-week period.
We are talking about a 10-week period to prevent disruption to cod spawning. In those 10 weeks, vessels can fish in other waters. The closure affects only two areas in the Firth of Clyde, and it is being done to improve fish stocks, which we hope will mean that their fishing in the future is more sustainable.
The minister’s letter to the Rural Affairs and Islands Committee on 11 January stated:
“We have reviewed the available scientific evidence to reassure ourselves that this approach is the most appropriate and proportionate.”
Can the minister set out the evidence base that guided the Scottish Government to that decision?
The decision is based on the best available evidence. I know that it creates challenges for local fishermen, but the marine directorate is currently reviewing its scientific observer programme with a view to enhancing data from the Clyde, working with the Clyde Fishermen’s Association. Work with our coastal state partners will begin this year to review the management measures that are in place across the northern shelf cod stock. That will provide a comprehensive route for managing northern shelf cod and the north-western sub-stock, which includes Clyde cod.
Rural and Island Communities (Budget)
To ask the Scottish Government what assessment it has made of the impact of its 2024-25 budget on rural and island communities. (S6O-02993)
The budget has required and delivered very difficult choices due to the pressures on our public services and the lack of funding from the United Kingdom Government. Despite that, the Scottish Government will invest over £1 billion in 2024-25 in the rural affairs, land reform and islands budget. Although the budget sets the spending envelopes, cabinet secretaries across the Scottish Government will develop and deliver programmes within their budgets. My officials and those of the cabinet secretary are supporting colleagues in assessing impacts on communities as more detailed plans are developed, including in relation to requirements under the Islands (Scotland) Act 2018.
The costs of delivering services are significantly higher in the islands, and they vary significantly between different island communities. Scottish Government ministers and the Convention of Scottish Local Authorities committed to reviewing the special islands needs allowance. SINA has not been adjusted for a number of years. What are the minister’s views on a potential review of SINA? Does she believe that the current settlement is truly delivering for our island communities, which depend on that support?
Pam Gosal will appreciate that the Cabinet Secretary for Rural Affairs, Land Reform and Islands is not here. I will pass back the specific asks about the review of SINA that she mentioned.
We were able to secure capital funding of £3 million to support implementation of the national islands plan, in addition to the £12 million over the past three years. That has already delivered a new nursery in Orkney, the refurbishment of community facilities in Papa Stour and the provision of workers accommodation in Mull. Pam Gosal should also not forget that the local government settlement for 2024-25 will provide island authorities with £1.5 billion. That is an increase of £74.7 million from the previous year.
The Cabinet Secretary for Wellbeing Economy, Fair Work and Energy, Neil Gray, met me, the chief executive of North Ayrshire Council and representatives of Arran’s hospitality sector on 29 November to discuss the sector’s concerns. I am delighted not only that Mr Gray listened but that, in the Scottish budget, island hospitality businesses will receive 100 per cent relief on their rates on a rateable value of up to £110,000. Will the minister advise the Parliament what the impact of that additional assistance will be on island hospitality businesses?
The 100 per cent non-domestic rates relief for properties in the hospitality sector on islands, which is capped at £110,000 per rate payer, is expected to be worth over £4 million in the next financial year. That shows that the Government values and supports island communities. That is in stark contrast to the Westminster Government’s pursuit of a hard Brexit, which is resulting in adverse impacts on island economies in general and hospitality businesses throughout Scotland in particular through the creation of new barriers to trade, increased costs and, especially, the loss of freedom of movement, which is resulting in and exacerbating labour shortages.
Last week, we debated the Scottish rural and islands youth parliament. Young people are calling for sustainable transport, food and a more compassionate politics. Is the Scottish Government confident that its budget is sufficient to invest in the futures of young people in rural and island areas?
If Beatrice Wishart will forgive me for putting my other hat on, I was in Orkney a couple of weeks ago, and I plan to visit Shetland to look at how we can maximise employment opportunities for young people, particularly through renewables. The ScotWind developments give massive opportunities for young people in island communities, particularly in the northern isles. [Interruption.] We have heard for many years that young people often go to college and university on the mainland but, although they would like to go back to the islands, they find it difficult to get jobs for which they are qualified to do that. I hope that the energy revolution that we are steering through will help in that respect. [Interruption.]
Mr Halcro Johnston, I would appreciate it if we did not get a running commentary from the front bench.
Food Labelling
To ask the Scottish Government, in light of reported concerns regarding food labelling being a devolved matter, what discussions it has had with the UK Government regarding the potential impact on Scotland’s food and drink sector of the reported proposal for “not for EU” labelling on food and drink products in the UK. (S6O-02994)
As the First Minister noted in his answer to Emma Harper last week, we share the well-documented concerns that the Food and Drink Federation Scotland and many food and drink businesses have. They have highlighted many concerns about the labelling plans. Extending the labelling requirement risks arbitrarily putting additional costs on Scottish businesses when we already face a cost of living crisis and increasing food costs.
Ms Gougeon wrote to the Secretary of State for Environment, Food and Rural Affairs before Christmas to ask for some much-needed clarification on the United Kingdom Government’s plans but, unfortunately, she has yet to receive a response.
A range of food and drink producers have voiced concerns that the additional labelling might add bureaucracy and put off consumers. If Scottish businesses are saying “‘not for EU’ is not for us”, how will the cabinet secretary advocate for them to the UK Government?
If people had known that taking back control actually meant adding more red tape, they might not have voted for Brexit. The food and drink sector has undoubtedly borne the brunt of the UK Government’s hard Brexit, which has disrupted supply chains over the years since it happened, created new barriers to trade and driven up overall food prices.
We are all paying a high price for a Brexit that Scotland did not vote for. The Cabinet Secretary for Rural Affairs, Land Reform and Islands has written repeatedly to the UK Government on a range of issues around that to urge it to address issues arising from Brexit, where it holds the levers to do so.
The “not for EU” label will support retailers and supermarkets to move food and drink products between Great Britain and Northern Ireland as smoothly as possible. It means that suppliers will not have to establish different production lines to be able to sell those goods in Great Britain and Northern Ireland, ensuring that those products stay on the shelves and that consumer choice is maintained.
Cabinet secretary, despite the grievance that you talked about, will you welcome the move, which is good for shoppers and farmers?
Speak through the chair, please.
I thank Rachael Hamilton for that party political broadcast—and, indeed, for the promotion that she gave me there.
I will quote back to her Balwinder Dhoot, director of sustainability and growth at the Food and Drink Federation, who said:
“Our members are really clear that the Government’s plan to extend ‘not for EU’ product labelling on a UK-wide basis will hamper growth, hitting investment, exports and jobs while increasing consumer prices and restricting the choice of products.”
That is the sector speaking—not me.
Border Target Operating Model
To ask the Scottish Government what its most recent assessment is of the potential impact of the border target operating model on rural affairs in Scotland. (S6O-02995)
The Scottish Government agreed to adopt the United Kingdom Government’s new model in order to bring in the much-needed biosecurity controls on imported goods. However, we continue to have a number of outstanding concerns and we are working with the UK Government to address them.
We urge the UK Government to pragmatically align its standards with the European Union and sign a comprehensive veterinary agreement, which would reduce the need for many of these controls.
The Scottish Government remains clear in its view that the best trading relationship for Scotland would be found as an EU member state.
The minister will be aware that Grangemouth, in my constituency, is the biggest export port hub in the country. I am concerned about the potential impact of the border target operating model. To what extent is the Scottish Government content that Grangemouth and other Scottish ports and exporters have all the specific details that they need to handle the import controls when they are introduced?
The cabinet secretary and I share Michelle Thomson’s concerns about that. The flat answer is that they do not have the necessary information at the moment. We spent considerable time and effort, during the development of the BTOM, balancing Scotland’s biosecurity and trade interests and ensuring that all stakeholders who trade with and from Scotland have the clarity that they need to adapt to post-Brexit trading. Regrettably, the UK Government has not engaged with us, as it had promised to do. The BTOM was signed in August but we have yet to have any kind of engagement or clarity. An awful lot of areas require further detail. We are also getting that feedback from those who work in our ports.
The new provisions largely address imports from the EU, so they are a step towards levelling the playing field. However, our exporters have had to cope with the EU’s own import controls for the past four years, whereas importers have faced minimal checks and burdens.
Farmers (Financial Support)
To ask the Scottish Government what financial support will be made available to farmers in 2024-25. (S6O-02996)
The Scottish Government will invest more than £1 billion in 2024-25 in the rural affairs, land reform and islands budget. We will continue to provide Scotland’s farmers, crofters and land managers with the most generous package of direct support in the United Kingdom, which is worth more than £600 million.
That is despite an autumn statement that falls far short of what we need and that has delivered a cut to the capital allocation of more than 10 per cent and a real-terms reduction in the total block grant.
In just two years, the common agricultural policy will have ended. The agriculture sector faces a very uncertain future, and I suspect that it does not feel that there has been much investment in it. Will the minister explain the decision-making process that has been followed by the Cabinet Secretary for Rural Affairs, Land Reform and Islands, which has cut or frozen funding for key agricultural schemes such as pillar 1 payments, the agricultural reform programme and the less favoured area support scheme at a time when farmers and crofters are already under severe pressure?
Yes. Farmers and crofters are under severe pressure, and that was not helped by our exit from the EU. The common agricultural policy gave certainty through multiyear funding. It is worth mentioning that, in addition to the direct payments that we give to farmers and crofters, there are payments that are not available to farmers in other UK nations. For example, we give £48 million of voluntary coupled support for beef and lamb producers and £2.7 million for the fruit and vegetable aid scheme.
Sue Webber will not want me to go into detail about all the other funding streams that rural Scotland has lost as a result of her party taking us out of the EU in a Brexit that Scotland did not vote for. The Republic of Ireland has received an allocation of £180 million of LEADER funding. I will not take any lessons from the Tories on how we support our farmers. We are doing what we can with what we have, but unfortunately the UK Government taking us out of the EU has made that extremely difficult.
We have a number of supplementary questions. They will need to be brief, as will the responses.
I am very glad that the minister touched on this, but I will never tire of, or apologise for, repeating it—direct payments. The Scottish National Party-led Government is paying farmers to farm and produce food, and that is the single most important support element that could be made available. Does the cabinet secretary share my bewilderment that the party that is so desperate to cast itself as the farmers’ champion has not lifted a finger to get clarity from its colleagues at Westminster about the quantum of funding that Scotland’s farmers can expect from 2025 onwards?
I agree with Jim Fairlie, and I share his palpable anger on this. There is no funding commitment from 2025, and we need clarity and certainty from the UK Government about rural funding after 2025. Farmers need to plan and know what they will be getting. As I have mentioned, the UK Government provides only yearly allocations that do not adequately replace EU funding. The EU CAP provided a multi-annual programme budget over a seven-year period.
Mairi Gougeon has made repeated requests to engage with UK ministers on this, including by writing several letters to Steve Barclay since his appointment, but she is still waiting for a response.
Agriculture is devolved, and it is crucial that Scottish Government policies are unhindered by the threats that are posed by the UK Internal Market Act 2020, the subsidy control regime and the lack of a long-term replacement for EU funding.
I am going to get one more supplementary question in, but I am going to have to ask Tory members—again—to desist from heckling while answers are being given.
The Scottish Government still owes Scottish farmers £46 million. Why is it cutting the budget for agriculture when it still owes that amount of money?
As Rhoda Grant can see, I am not Mairi Gougeon, and she is in charge of the budget allocations. However, the fact that Rhoda Grant has raised the question in the chamber means that it is on the record. I will certainly pass it to Mairi Gougeon and get her to write to Ms Grant.
Salmon Industry (Economic Importance)
To ask the Scottish Government what assessment it has made of the importance of the salmon industry for Scotland’s economy. (S6O-02997)
Scotland’s salmon industry is a significant contributor to our economy. The Scottish Government’s annual marine economic statistics and our fish farm production surveys show that.
In 2021, aquaculture generated £472 million gross value added, 96 per cent of which was from the salmon industry. In 2022, salmon farming achieved a record value of more £1.2 billion. A Scottish Government-commissioned report in 2018 examined aquaculture’s wider economic impacts and showed that the sector supported 11,700 jobs and generated £885 million GVA.
Our vision for sustainable aquaculture sets out our ambition to grow the sector and makes clear our support for a sustainable industry.
Given the significant sums involved in gross value added and the extremely high number of jobs that are supported by the salmon industry in Scotland, which the minister referred to, including 600 jobs at Mowi Salmon in Rosyth, in my constituency, when can we expect to see progress on full implementation of the Griggs review recommendations, which were made almost two years ago?
I am pleased to pass on that the cabinet secretary is content with the progress that has been made since receiving the ambitious recommendations in the independent review. Last July, she published the “Vision for Sustainable Aquaculture”, and progress has been made on the consenting recommendations with the development of a pilot proposal for a new pre-application process for fin-fish farm applications.
The cabinet secretary looks forward to working with stakeholders to further consider the recommendations of the Scottish Science Advisory Council. She hopes that, in making progress and allowing sensible time for due diligence and collaboration with the Scottish aquaculture council and others, we will be able to implement the best possible solutions.
We often hear about the economic benefit that salmon farming brings for Scotland, despite the fact that the vast majority of profits go to foreign-owned multinationals. However, has the Scottish Government assessed the cost of the environmental damage that the industry causes, which includes damage to blue carbon sites, precious fish nurseries, commercial shellfish stocks and our iconic wild Scottish salmon?
I do not recognise the picture that Ariane Burgess paints of Scotland’s aquaculture sector. All fish farms in Scotland have to meet strict environmental guidelines. Local authorities consider potential environmental impacts of farms as part of the planning application process, and they are advised by a range of statutory consultees. The Scottish Environment Protection Agency also monitors the environmental impacts of all fish farms, with no exceptions, to ensure safe management.
As Ariane Burgess will know, the reasons for the decline in wild salmon stocks are wide ranging and extremely complex. We take that decline very seriously, and we are working to ensure the protection and recovery of that iconic species.
NHS Recovery, Health and Social Care
The next portfolio is NHS recovery, health and social care. Any member who wishes to ask a supplementary question should press their request-to-speak button during the relevant question. Again, there is a lot of interest in asking questions, so I make the usual appeal for brevity in questions and responses.
Question 1 is not lodged.
Community Mental Health Services (Funding)
To ask the Scottish Government, in light of the announcements made in its budget, what action it is taking to ensure that well-established community mental health services are appropriately funded. (S6O-02999)
We continue to invest in quality community health services to support our prevention and early intervention priorities. That includes providing investment of more than £2.1 billion for primary care and supporting spending in excess of £1.3 billion for mental health, which will continue to enable record numbers of mental health staff to provide more varied support and services.
The mental health and wellbeing delivery plan commits to improving mental health service provision in primary care settings through a focus on prevention and early intervention in the community. That will include the development of multidisciplinary teams in general practice and maximisation of the role of community mental health teams, digital provision and NHS 24 to make access simpler and quicker.
Morven day services centre in Kilmarnock, which has been supporting people with learning difficulties and mental health issues for more than three decades, has had its funding withdrawn by the local health and social care partnership. The decision has been described as “devastating” by people who use the centre, and it will almost certainly lead to added pressure being put on local social services and the national health service, as people who would otherwise have gone to Morven day services are forced to seek services elsewhere.
Does the minister agree that closing established community mental health services such as Morven day services to achieve short-term budget savings is exactly the opposite of the approach that we should be taking with mental health in Scotland? Will she commit to exploring whether any alternative sources of funding are available through the Scottish Government’s agencies to protect services such as the Morven day services centre?
I certainly agree that investment in social care makes a profound difference to people’s lives, and that it is vital that we maintain services for people with learning disabilities that are based in communities.
However, there is a requirement for local health and social care partnerships and local democratically accountable organisations, such as local councils, to be locally accountable for decisions, to set priorities, to understand the landscape that exists in their local area and to procure services to meet the needs of their population. It would not be appropriate for me, as a Government minister, to intervene in those processes, but I absolutely recognise the importance of good high-quality social care in transforming people’s lives.
Although it is appropriate for local services to be decided locally, the minister cannot abrogate her responsibility for cutting the resources that are available to allow those decisions to be made in the best interests of local communities.
In 2022-23, the communities mental health and wellbeing fund was oversubscribed, with almost half of all applicants missing out. Does the Scottish Government accept that more support needs to be provided for community-based mental health services? What assessment has it made of the insufficient capacity of the communities mental health and wellbeing fund to meet the huge demand from local authorities and local health and social care partnerships? How is it helping to support the high number of unsuccessful applicants? If those services fail, that will surely have long-term consequences.
We invest in local communities in a number of ways, through local authorities and the third sector interface fund, directly to support mental health organisations and to have a mental health impact in our communities.
The Scottish Government is absolutely committed to delivering high-quality services and to supporting households, but we are in an extremely difficult financial situation, and the financial pressures right across health and social care are by far the most challenging since devolution, because of rising inflation and the on-going impact of Covid and Brexit.
We are making really difficult decisions to balance the budget. We are prioritising spending to support services and to make a record pay offer to our NHS staff to support them through the cost of living crisis and to avoid industrial action. We will absolutely maintain our focus on progressing those key commitments to support mental health. I have worked really hard to maintain spending and to protect mental health funding from the situation that we find ourselves in—
Thank you, minister. We have to move on. I ask that supplementary questions be a question, rather than a question in four parts.
I call Beatrice Wishart. Please be brief.
The pandemic highlighted the mental health crisis in Scotland and the impact on young people who are showing high levels of mental health issues. The Scottish rural and islands youth parliament wants service improvements, with interventions including the creation of social support places and solutions that are tailored to specific age groups. Given the £30 million budget cut that the Scottish Government has made, is it really committed to improving mental health services for young people?
We are absolutely committed to improving mental health services for young people. It was a delight for me to meet those young parliamentarians in this building last week. We have made massive and sustainable improvements in our child and adolescent mental health services investment. Waiting lists are falling. The median time in which to be seen is now 10 weeks, so one in two children who are referred to CAMHS is seen within 10 weeks, and 13 out of 14 of our territorial health boards have all but eliminated long waits. I agree that progress needs to be made, but Beatrice Wishart can see from our track record that progress is being made.
Diabetes (Support)
To ask the Scottish Government what action it is taking to support people with diabetes. (S6O-03000)
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.
In February 2021, we published a refresh of the “Diabetes Improvement Plan: Diabetes Care in Scotland—Commitments for 2021-2026”. It sets out our aims and priorities to support those living with diabetes. The implementation of the plan is overseen by the Scottish diabetes group, with multiple well-established projects running, including improving diabetes education, prevention of foot ulceration, in-patient care and supporting people with diabetes during and after pregnancy. A major focus of the plan is to increase access to diabetes technologies. Since 2021, the Scottish Government has invested more than £19 million of additional funding to support that commitment.
I thank the minister for that answer. Many constituents in Glasgow have contacted me about the worryingly long periods of time fro which they are waiting for insulin pumps, with some people waiting more than 12 months. When will the Government’s plan on technologies to support people with diabetes be rolled out, and what can the minister do to help my constituents to get the diabetes technologies that they need, in the meantime?
As I said in my original answer, we have increased the level of funding for such technologies. Between 2016 and 2021, the Scottish Government invested £10 million of additional funding specifically to support increased provision of insulin pumps and continuous glucose monitors. Between March 2021 and March 2022, a further £19.6 million was allocated to NHS boards to support increased access to diabetes technologies, including closed-loop systems. In November 2023, the Scottish Government provided £1.5 million of additional support, via the outcomes framework for insulin pumps and diabetes technologies.
It is important to note that that funding is in addition to, not a replacement for, local budgets. Baseline funding is provided to NHS boards, which are expected to continue funding provision locally to meet patients’ needs. We also work closely with the diabetes managed clinical networks in each health board to identify and resolve any issues that are raised—such as those that Pam Duncan-Glancy has raised in relation to Glasgow—regarding access to diabetes technologies, in order to ensure that resource is targeted at supporting the needs of the local populations.
We absolutely recognise that there are significant challenges for NHS services—
Thank you, minister. I will take a couple of brief supplementary questions. Emma Harper is first.
As we know, diabetes technology can significantly enhance people’s quality of life. I remind members that I have type 1 diabetes and am a tech and pump user. However, there is disparity among health boards in Scotland in term of availability of diabetes technology. Will the minister comment on how the Scottish Government is supporting health boards to deliver diabetes technology to those who would benefit from it?
I will take a quick moment to recognise Emma Harper’s on-going interest in the area and her use of her experience to highlight the issue to our population.
As I said, we have invested £19.6 million of additional funding specifically to support the increased provision of diabetes technologies, but we recognise that significant challenges remain. It is difficult for national health service boards to provide technology to everyone who would benefit from it, under their current models of care, and variation exists. We work closely with the diabetes managed clinical networks in each board to identify and resolve any such issues.
We recently commissioned the development of a national onboarding team. That pilot will provide dedicated support to NHS boards and will roll out technology faster and more efficiently. A key focus of that project is on reducing regional variation and making that technology more equitable to access across Scotland.
I refer members to my entry in the register of members’ interests. I am a practising NHS GP.
Yesterday, a parliamentary inquiry that was chaired by former Prime Minister Theresa May published its report into type 1 diabetes and disordered eating in England. The former PM also shared her personal experience of living with type 1 diabetes, which is echoed by similar stories that I have read in reports that have been published by Diabetes Scotland. Will the minister provide clarity on what plans the Scottish Government and NHS Scotland have for treatment of type 1 disordered eating?
We absolutely recognise the link between mental health, disordered eating and type 1 diabetes, and we have made a significant investment in the link between mental health and diabetes. The report by Theresa May is important. It is absolutely to be commended that she has used her experience to highlight that vital area. We, as a Government, are keen to read the report and see what we can learn from it.
Forth Valley University College NHS Partnership
To ask the Scottish Government what assessment it has made of the Forth Valley university college NHS partnership’s impact on the delivery of health services in Forth Valley. (S6O-03001)
The partnership, which was launched in October 2022, is the first formal regional partnership between a health board, university and college, and is an exemplar of cross-public-sector engagement among anchor institutions in Scotland. It is focusing on learning, career development, research and innovation. We are interested in its progress, which includes the January 2024 launch of a fast-track nursing course at Forth Valley College to widen access to the undergraduate nursing programme at the University of Stirling, and supporting new employability placement opportunities in local health services.
We recognise that those strong links have the potential to drive forward research and innovation, improve health outcomes and improve attraction into health careers locally. We will continue to engage with NHS Forth Valley and its partners to understand the on-going impact of the new partnership on service delivery.
Would the Scottish Government encourage other health boards and education establishments to replicate that partnership model?
I encourage other partners to consider it. I put on record my congratulations to the Forth Valley university college NHS partnership and the collaborative approach that it is taking to working together.
As a Government, we encourage other local partners to look closely at the approach that has been taken in Forth Valley, as it provides an opportunity to drive innovation and support service delivery improvement.
Learning is critical to attracting the future national health service workforce and ensuring that they have the skills and experience to help healthcare. It is clear that recruitment and retention are issues for NHS Forth Valley, so what actions is the Scottish Government taking to ensure that the most experienced candidates are attracted to the workforce in order to drive forward innovation, improvement and health and wellbeing?
We are taking forward a range of work to attract people into our healthcare professions. The NHS nursing and midwifery task force, which I chair, is looking at a range of work that we can do to encourage people into nursing and midwifery. That involves a range of stakeholders—including our higher and further education institutions, regulatory bodies, trade unions and national health service boards—working collaboratively to identify the key measures that we can take to address the issue that Alexander Stewart mentioned.
Community Hospitals Network
To ask the Scottish Government what action it is taking to support and improve the network of community hospitals. (S6O-03002)
The Scottish Government is committed to supporting everyone in Scotland to receive the very best health and social care in the most appropriate setting. That includes community hospitals, which form a vital part of the health and social care system. Community hospitals are managed by either integration joint boards or national health service boards, which consider how best to support people to move from acute hospitals and receive intermediate care when it is not yet appropriate for them to receive that care at home. To support that work, a national community hospital group has been established to link professionals so that they can seek assurance and share best practice on efforts to support system flow in and out of community hospital settings.
I am pleased to hear that the cabinet secretary agrees that patients and families should rightly expect to have health and social care services available as close to home as possible, whether in an urban or a rural setting.
I have highlighted the critical role of cottage hospitals with the health secretary on numerous occasions, because it is hugely important that step-down care, palliative care and other treatments are offered locally by dedicated health professionals.
Cottage hospitals have previously provided such services, but two of them in my constituency, in Kirkcudbright and Newton Stewart, remain closed. Does the cabinet secretary agree that it is totally unacceptable that there are no clear plans for their future? What can he do to ensure that those facilities and the services that they deliver are as close to home as possible?
Community hospitals are an essential part of our health and social care system. They provide a wide range of local out-patient and in-patient services from mental health services, palliative and end-of-life care through to rehabilitation, minor injuries units, out-patient clinics and, in some cases, access to diagnostic services.
It is important that those services are delivered at the local level. I am aware of the issue that the member raised, and I wrote to him on that matter in November last year. I understand that the local health board is considering the use of community hospitals in its area. I encourage the board to ensure that it remains engaged with the local community on how best to deliver and design those services.
Previous research into community hospitals in Scotland found that,
“Despite the range of primary and specialist care services offered at the community hospitals, staff and management in both settings felt that the potential for local provision had not yet been fully realised.”
What specific work is the Scottish Government undertaking to ensure that our highly valuable community hospitals realise their full potential in delivering for local people?
As I mentioned, we established a national community hospital group to provide a link between professionals so that they can seek assurance and share best practice, in an effort to support the system more effectively.
General Practitioner Contract (Rural Practices)
To ask the Scottish Government whether it plans to take any action on any concerns that it may have regarding the 2018 GP contract in relation to rural practices. (S6O-03003)
The Scottish Government established the remote and rural working group, which was chaired by Professor Sir Lewis Ritchie, in response to the concerns of rural general practitioners about the 2018 contract. The group produced the “Shaping the Future Together” report in January 2020, and various actions have been undertaken as a result.
The 2018 GP contract is based on allowing GPs to focus on their expert medical generalist role by funding health board-employed multidisciplinary teams. Health boards, health and social care partnerships and GPs should work together to ensure that the transfer of services meets the needs of local patients.
It is clear that the 2018 contract has not worked for rural practices. That issue is now being compounded by NHS Highland withdrawing funding for GP-enhanced services. Will the Scottish Government address that with NHS Highland, as it clearly further impacts GPs’ ability to provide services for conditions such as diabetes and alcohol misuse, to mention only two?
I recognise that there are some challenges with the GP contract in rural areas. That is why we established the group under Sir Lewis Ritchie to look at some of the issues, and measures are being taken to address them. For example, through the creation of our rural health centre, we are doing work with a focus on primary care in rural areas to look at what further actions can be taken to support and sustain them.
On the specific matters relating to NHS Highland, I would want to make sure that the board, when considering any potential changes, fully engages with local GP practices to ensure that they are properly consulted on the implementation of those changes.
Can the cabinet secretary provide any update on the national centre for remote and rural health and care and how it will support the sustainability and capacity of primary care in rural communities?
The national centre for remote and rural health and care was launched in October last year and is being delivered by NHS Education for Scotland. The centre will work with health boards and health and social care partnerships on improvements to the sustainability and capability of remote, rural and island primary and community care services, avoiding a one-size-fits-all approach. A programme of rural-specific training sessions is in development and two pieces of work are already in progress, focused on improved support and training for remote and rural dispensing practices and developing supervisory training hubs.
What does the cabinet secretary have to say to patients whose multidisciplinary teams can be 60 miles away, which worsens health inequalities? Indeed, those who face the bigger barriers find it more difficult to travel to centralised locations.
I recognise that, in rural areas, there can be challenges because of the remoteness of some of the service delivery. When boards are establishing and taking forward the planning for multidisciplinary teams in primary care, it is important that they address those issues as effectively as possible by having those teams as close to patients as possible. I understand that, in some circumstances, that may not be possible, but it is important that, where boards can achieve that, they do so.
Dementia (Support)
To ask the Scottish Government whether it will provide an update on the support that is available for people living with, or affected by, dementia. (S6O-03004)
As is detailed in our new dementia strategy for Scotland, which launched in May last year, we are committed to improving the experiences of our dementia communities, including through our investment in dementia care and support by health and social care partnerships of £2.2 billion in 2022-23, which is a 14 per cent increase since 2014.
Our strategy recognises the need to build on our world-leading commitment to provide 12 months of post-diagnostic support following a dementia diagnosis and to expand the resilience of our dementia communities. More than £9.5 million has already been directly invested nationally to achieve that since 2021.
We have worked collaboratively with people with lived experience and national and local partners to develop our first two-year delivery plan, which will be published next month.
Organisations such as Town Break and meeting centres provide essential support to those living with dementia and their carers in Dunblane and Stirling. From peer support to social activities, such local independent groups provide exactly the care that people need to add life to years. However, the future of those groups is at risk and the local health and social care partnership’s funding for dementia services is unclear for the next year. Does the minister agree that all efforts should be made to properly fund such community-led dementia support groups as part of the Government’s strategy?
Our strategy, which was developed in partnership with the Convention of Scottish Local Authorities, makes clear the importance of community support and the role of localities and the people who live there in deciding what dementia services and support fit their needs. In addition to the £2.2 billion that I set out, which is provided to HSCPs to fund dementia care, the Scottish Government has invested £1.5 million via Age Scotland since 2021 to enhance and sustain community-led support. I have personally seen the impact on people with dementia and their families and we are committed to continuing to work with local partners to improve access and to better co-ordinate available support.
The minister will be aware of the link between audio and visual sensory loss and dementia. Given that there is such a strong connection, highlighting how important audiovisual stimulation is to keeping parts of the brain active, why are routine eyesight or hearing tests not provided as standard in our elderly care facilities?
I am happy to write to the member with further supplementary information, but she will be aware that everyone in Scotland has access to free eye testing. Very often, optometrists go out into community settings when people are not able to access them on the high street. I will ask my colleague Jenni Minto to update the member on progress with community audiology.
Demographic Changes (Impact on NHS Services)
To ask the Scottish Government what research it has undertaken on the impact of changing demographics on national health service services. (S6O-03005)
The Scottish Government has not undertaken specific research on the impact of changing demographics on NHS services. However, Public Health Scotland is currently undertaking research that will inform discussions on the impacts on NHS services as a result of the projected changes to the burden of disease and Scotland’s demographics. It is anticipated that that research will be published on Public Health Scotland’s website by the end of 2024.
As the cabinet secretary is aware, there are more than 1 million Scottish residents aged over 65, and that number is increasing. Living longer can be a plus, but with age, regrettably, come more demands, as well as specific demands on the NHS. Does the weighting of the NHS Scotland’s resource allocation committee—NRAC—formula, which allocates resources to NHS boards, need to be reviewed in the light of the increasing number of older people?
The NRAC formula takes into consideration a range of factors, including the demand for healthcare services within a health board area. The member may also be aware that we have committed to undertake a review of the NRAC formula. However, that piece of work is complex and will take some time. On the broader point that the member raises, it is critically important that we look at the potential impact that the increasing burden of disease, which we will face over the course of the next 20 years, will have on NHS services, as a key part of dealing with the challenges. That is exactly what the piece of work that is being carried out by Public Health Scotland will assist us to understand, so that we can then evaluate the potential impact of the changes in the years ahead.
Unfortunately, we have run out of time for portfolio questions on NHS recovery, health and social care. I apologise to those members whom I was unable to call. There will be a brief pause before we move to the next item of business, in order to allow members on the front benches to change position.
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