Scottish Parliament, 8 February 2023

346 contributions from 59 members. The official report.

Covid-19 Recovery and Parliamentary Business

Liam McArthur (Liberal Democrat, Orkney Islands)

Good afternoon. The first item of business is portfolio question time, and the first portfolio is Covid-19 and parliamentary business.

I remind members that questions 5 and 7 have been grouped together, so I will take supplementaries on those questions after both have been answered. Members who wish to ask a supplementary should press their request-to-speak button during the relevant question. I advise the chamber that there is an awful lot of interest in asking supplementaries, so, if we can have questions that are devoid of lengthy preambles and answers that are as brief as possible, we will get through them all the more quickly.

Covid-19 Recovery (Assessment of Policies)

Christine Grahame (Scottish National Party, Midlothian South, Tweeddale and Lauderdale)

1. I will try to set a good example for once, Presiding Officer.

To ask the Scottish Government what assessment it has made, as part of its cross-Government co-ordination of Covid recovery policies, of the wider on-going impact of Covid-19, including on the economy. (S6O-01868)

John Swinney (Scottish National Party, Perthshire North)

The Covid recovery strategy brings together more than 70 actions that are supporting those who have been most impacted during the pandemic and the on-going cost crisis by increasing financial security for low-income households, enhancing the wellbeing of children and young people, and creating good, green jobs and fair work.

That activity is supported by the themes of the Scottish Government’s national strategy for economic transformation and by work that involves support for digital recovery and support for the energy sector through the energy transition fund. We are also providing significant investment to support businesses, including by providing almost £0.5 billion pounds more than the funding that we received from the United Kingdom Government.

Christine Grahame (Scottish National Party, Midlothian South, Tweeddale and Lauderdale)

I ask, with specific reference to my constituency, whether we have any data on the impact on the economies of Midlothian and the Borders. If the Deputy First Minister does not have that to hand, will he please write and provide me with it?

John Swinney (Scottish National Party, Perthshire North)

I am very happy to draw out as much detailed information as I can in a follow-up response to Christine Grahame. However, in relation to some key indicators, we have historically low unemployment and historically high employment levels across Scotland. Those factors will be felt acutely in areas such as the Borders and, in particular, in Midlothian, where there is such strong accessibility to labour markets. I will look to see what more detailed information I can provide to the member.

The Deputy Presiding Officer

We have a few brief supplementaries.

Murdo Fraser (Conservative, Mid Scotland and Fife)

One of the economic impacts of Covid has been the acceleration in the decline of traditional retail centres. Just this week, we have seen the closure of M&Co stores across Scotland, which will contribute to that. Has the Scottish Government done any assessment of the impact on traditional town and city centres of the expansion of working from home across the public sector?

John Swinney (Scottish National Party, Perthshire North)

Obviously, town centres and the retail community will be affected by a range of different factors. Covid and the impact of lockdown will be one, the move towards the greater use of online retail opportunities will be another, and a third will undoubtedly be the impact of proportionally more people working at home since the pandemic than before the pandemic.

The Government is actively undertaking work to look at the impact on town centres, and parliamentary committees have reported on the subject. All those different factors are researched and are reflected in the thinking that the Government brings together in its retail strategy.

Paul Sweeney (Labour, Glasgow)

One of the major legacies of the Covid pandemic in Scotland has been its impact on mental health. What is the Deputy First Minister’s response to reports that there were no mental health beds available in Scotland last weekend? What steps is the Government taking to honour its pledge to increase spending on mental health to 10 per cent of the total national health service budget, given that funding for the coming financial year has been frozen?

John Swinney (Scottish National Party, Perthshire North)

The mental health budget has increased, and we have greater capacity to support individuals in order to assist in their recovery. The Government is taking a variety of other steps to enhance community mental health resources in our society; assistance to school communities is an example that comes to mind. The Government will endeavour, where the resources allow, to expand the investment in mental health and wellbeing services, as it recognises the importance of supporting people in their recovery.

Covid-19 Inquiry (Update)

Jamie Halcro Johnston (Conservative, Highlands and Islands)

2. To ask the Scottish Government whether it will provide an update on the Scottish Covid-19 inquiry. (S6O-01869)

John Swinney (Scottish National Party, Perthshire North)

As an independent public inquiry, it is for the Scottish Covid-19 inquiry to comment on its work as it progresses, including through its website: covid19inquiry.scot. In its role as sponsor, the Scottish Government remains committed to providing operational support, as the chair considers appropriate and necessary, in order to enable the inquiry to carry out its independent work and to ensure that the progress that has been made so far is continued. We want the inquiry to be delivered at speed, addressing the range of questions that people have, so that we can learn and benefit from any lessons as early as possible.

Jamie Halcro Johnston (Conservative, Highlands and Islands)

It has been reported recently that the former chair of the Scottish Covid-19 inquiry, Lady Poole, raised several issues with the inquiry before her resignation and that the Deputy First Minister personally offered to make a phone call to try to get her to change her mind, although she declined to do so. It appears that numerous issues with the inquiry were piling up and that Lady Poole felt that she had no option but to step down. Why did the Deputy First Minister let those problems build up to the point of resignation, rather than addressing them at an earlier stage? Given that millions of pounds of taxpayers’ money have already been spent on the inquiry, what lessons have been learned to ensure that the same issues, delays and costs do not arise in the future?

John Swinney (Scottish National Party, Perthshire North)

Mr Halcro Johnston’s question raises a perspective on an independent public inquiry that must be countered. Conservative members would be outraged if I were to interfere in the operation of an independent public inquiry. Indeed, Mr Fraser, who is sitting on the front bench, accused me of so doing. We have one member of the Conservative Party, Mr Halcro Johnston, asking me to interfere in an inquiry and another Conservative member, Mr Fraser, alleging that I am already doing just that.

The law is very clear on independent public inquiries, and I have rehearsed the point in previous parliamentary statements. The law is clear that, once a chair is appointed, it is up to them to run the public inquiry and it is not for ministers to interfere. I do not interfere.

Covid-19 Recovery (Assessment of Policies)

Willie Coffey (Scottish National Party, Kilmarnock and Irvine Valley)

3. To ask the Scottish Government what cross-Government assessment it has made of the impact of its Covid recovery policies, including whether any might continue into the future. (S6O-01870)

John Swinney (Scottish National Party, Perthshire North)

The Covid-19 recovery strategy contains a range of actions, many of which will continue beyond the lifetime of the strategy. The principles of the Covid-19 recovery strategy helped to inform the 2023-24 Scottish budget, which prioritises eradicating child poverty, transforming the economy to deliver a just transition to net zero and achieving fiscally sustainable public services. The Scottish Government will continue to prioritise policies that support those who are in the most need.

I co-chair the Covid-19 recovery strategy programme board, alongside the president of the Convention of Scottish Local Authorities. Together with partners, we oversee recovery activity that supports people in Scotland, particularly those who are most affected by the pandemic and the on-going cost crisis.

Willie Coffey (Scottish National Party, Kilmarnock and Irvine Valley)

I thank the Deputy First Minister for that answer, which provided a useful contrast to the earlier question.

The Deputy First Minister will be aware of some of the more positive outcomes from Covid, such as the digital transformation of the workplace—and the Parliament—and local project initiatives that initially emerged as emergency support, but which have become an important part of local community work not only in my constituency but in the impressive work of Engage Renfrewshire, which the Local Government, Housing and Planning Committee saw on Monday.

Does the Deputy First Minister share my view that those positive developments, born out of Covid, are making a real difference to people and communities? Will he consider retaining funding models for important community work in the future, rather than allowing that work to be lost simply because the Covid funding has come to an end?

John Swinney (Scottish National Party, Perthshire North)

There is a lot of merit in the points raised by Mr Coffey. We saw tremendous development in innovative community practice during Covid, whereby solutions were found by communities for individuals. The Government is intent on encouraging and nurturing that approach.

It is important that we are on our guard against a return to old ways of working. Some of the new ways of working that were developed during Covid have been of great benefit and advantage to our society and our communities. We want to ensure that we preserve those. I assure Mr Coffey that the Government is trying to design its funding interventions, particularly for measures such as the Dundee pathfinder work, to do exactly that.

Jackie Baillie (Labour, Dumbarton)

Last week, I met Unite the union and concerned employees from the Glasgow Lighthouse lab to discuss the future of the facility, in the light of concerns about further redundancies in the coming weeks. The cabinet secretary will be aware that the lab, which is Scotland’s flagship Covid-19 testing facility, processed more than 26 million tests but has already lost experienced and highly skilled employees, including sample handlers and lab technicians, in a previous round of redundancies.

Will the cabinet secretary outline what meetings the Scottish Government has had with the University of Glasgow regarding the future of the Glasgow Lighthouse lab? Given that Covid has not gone away, will he intervene to ensure that that important capacity is retained?

John Swinney (Scottish National Party, Perthshire North)

From the budget discussions that we had at the COVID-19 Recovery Committee, Jackie Baillie will be aware that the Government is retaining enhanced testing facilities beyond those that we had prior to the Covid pandemic, to ensure that we have the capability and capacity to undertake testing activity.

I will inquire about specific dialogue between health ministers and the University of Glasgow in relation to the Lighthouse lab, but Jackie Baillie should be assured of the Government’s commitment to ensuring that we have the appropriate measures in place to deal with the Covid pandemic. The pandemic is, of course, still with us, but its prevalence is, thankfully, much lower than has been the case in the past, and we have much greater population protection through the vaccination programme.

Covid-19 Recovery (2023-24 Budget Allocation)

Elizabeth Smith (Conservative, Mid Scotland and Fife)

4. To ask the Scottish Government how it plans to spend the proposed Covid recovery portfolio 2023-24 budget allocation. (S6O-01871)

John Swinney (Scottish National Party, Perthshire North)

The Covid recovery portfolio supports the Scottish Government’s commitment to renewing public services through public service reform, the delivery of the Covid recovery strategy—which is supporting those who have been most impacted during the pandemic and on-going cost crisis—and its contributions to the co-ordination of recovery activity across the Scottish Government.

As detailed in the 2023-24 budget statement, the budget line includes a range of commitments, including work to support the operation of the Scottish public inquiry into the handling of Covid-19 and work on preparedness, assessment and co-ordination of concurrent risks across the Scottish Government.

Elizabeth Smith (Conservative, Mid Scotland and Fife)

On a related issue, at the end of last year, the letter that Richard McCallum, the Scottish Government’s director of health finance and governance, sent to integration joint boards caused considerable concern that a total of £331 million of Covid money across IJBs would be clawed back by the Scottish Government. The Scottish Government said that that money

“is being used to fund Covid pressures across the”

health

“sector and for no other purpose.”

Can we get some clarity on exactly what that money is being spent on?

John Swinney (Scottish National Party, Perthshire North)

It is pretty obvious that the budget is under enormous financial pressure. Liz Smith is a member of the Finance and Public Administration Committee, and I have been completely candid about the challenges that I face in balancing this year’s budget because of the impact of inflation and the increased costs with which we are wrestling. I have come to Parliament to reallocate £1.2 billion of resources to meet the funding pressures. It is no secret that we face those issues and pressures, but the Government is acting to address them.

In relation to IJB funding, it is elementary common sense that, if IJBs hold reserves that can be utilised to support front-line activity, that is the Government’s clear preference.

Paul O'Kane (Labour, West Scotland)

Given the pressures that are faced by unpaid carers—one of the groups who have been most adversely affected by the pandemic—not least due to rising energy bills, as has been articulated in the chamber during First Minister’s question time, as well as their needs in the recovery phase, what does the Deputy First Minister intend to do to support them through the Covid recovery budget, not least in relation to testing, antivirals and personal protective equipment?

John Swinney (Scottish National Party, Perthshire North)

As Mr O’Kane might be aware, there is provision in the health budget for the maintenance of pandemic preparedness in relation to many of the issues that he raises, such as PPE and testing arrangements, as I rehearsed in my answer to Jackie Baillie. That provision has been made on a prudential basis. We all hope that we will not need to increase the scale of investment that is required in that regard, but there is provision in the budget to enable that to happen. Support would be available to those who required it, and I imagine that, in many cases, carers would be eligible for that support.

Covid-19 Recovery (Long Covid Data Collection)

Richard Leonard (Labour, Central Scotland)

5. To ask the Scottish Government how its cross-Government co-ordination of Covid recovery policies is supporting data collection to assess the impact of long Covid. (S6O-01872)

John Swinney (Scottish National Party, Perthshire North)

The Scottish Government is committed to delivering a fair recovery for everyone in Scotland, particularly the people who have been most affected by the pandemic, which includes those affected by long Covid.

We are supporting activity to improve the collection of clinical data on the prevalence and healthcare needs of people with long Covid to inform the planning and delivery of services. Officials are working with NHS National Services Scotland’s long Covid strategic network to improve data collection as a priority. The network is taking forward a dedicated workstream to agree outcomes, indicators, monitoring and evaluation to accelerate progress.

Richard Leonard (Labour, Central Scotland)

In August, the Cabinet Secretary for Health and Social Care said in a parliamentary answer to me that the number of people diagnosed with long Covid in Scotland was

“a matter for the NHS Boards. The information requested is not held centrally.”

In the same answer, he said that the Government recognised

“that accurate data on the number of people diagnosed with long COVID is needed to forecast and plan for ... healthcare services arising from long COVID.”

Does the Cabinet Secretary for Covid Recovery—who is the Deputy First Minister, the minister in charge of statistics and the minister in charge of Government strategy—agree with the Cabinet Secretary for Health and Social Care that that is

“a matter for the NHS Boards”—[

Written Answer

s, 24 August 2022; S6W-10046.]

or does he recognise the benefit of the Scottish Government collecting the data, publishing the data and keeping an accurate record of that data to plan and properly resource nationally the vital services that long Covid sufferers so desperately need?

John Swinney (Scottish National Party, Perthshire North)

I would make two points in relation to Mr Leonard’s question. First, I reiterate what I said in my original answer. Work is under way with NHS National Services Scotland’s long Covid strategic network to improve data collection. That substantively addresses the point that Mr Leonard puts to me.

Secondly, in relation to support for people with long Covid, the Government is very clear that we must ensure that anybody who is experiencing ill health, whether that is from long Covid or anything else, is able to access the appropriate level of clinical care to support their needs and requirements. That is primarily undertaken through access to the general practitioner network in Scotland. I would encourage anybody who is experiencing ill health to pursue those options and to ensure that they secure the necessary care to which they are entitled.

Covid-19 Recovery (Impact of Long Covid)

Stuart McMillan (Scottish National Party, Greenock and Inverclyde)

7. To ask the Scottish Government what discussions it has had as part of its cross-Government co-ordination of Covid recovery policies regarding the wider impact of long Covid, including on the economy and workforce. (S6O-01874)

John Swinney (Scottish National Party, Perthshire North)

The Scottish Government recognises the impact that long Covid can have on the health and wellbeing of the people who are affected, including on their ability to stay in employment. Although there have been increases in the numbers of people who are economically inactive due to sickness since before the pandemic, the extent to which that is attributable solely to long Covid is not yet clear.

We are investing in scientific efforts to understand and treat long Covid, and we have made funding available to national health service boards and partners to deliver the best local models of care for assessment, diagnostic tests and support for the on-going management or treatment of symptoms.

Through our fair work agenda, we are also supporting employers and explaining to them how they can support workers who are living with long Covid to remain in employment.

Stuart McMillan (Scottish National Party, Greenock and Inverclyde)

I am concerned that people with long Covid will find themselves locked out of employment if they are not given adequate support to return to work. That is especially true if the person’s job cannot be done from home, which is the case for nurses, for example. What is the Government strategy to help to ensure that people working in our NHS who are suffering from long Covid are supported to return to work where possible and, if they cannot return to work, to ensure that other options are explored to help them to stay in employment?

John Swinney (Scottish National Party, Perthshire North)

We have a priority across the whole of Government to maximise the available level of participation in the labour market. We want to maximise the number of people who are available to actively contribute to the labour market.

As I said in my earlier response to Christine Grahame, we have low levels of unemployment and high levels of employment, and the labour market is tight. Therefore, we are encouraging people who have long Covid to return to work, and all the necessary clinical support, mental wellbeing support and any other assistance that is required should be available to them. If there is a case for individuals to find alternative employment, we should be open to providing the training and skills enhancement activity that will support them in making the transition.

Parliamentary Reform (Debating Time)

Stephen Kerr (Conservative, Central Scotland)

6. To ask the Scottish Government what plans it has to propose time for a debate in the Parliament on parliamentary reform. (S6O-01873)

George Adam (Scottish National Party, Paisley)

I thank Mr Kerr for his question. The Scottish Parliament is responsible for all matters relating to its functions and internal operation. The Government would encourage any member wishing to propose reform of current parliamentary procedures to raise such proposals with the Standards, Procedures and Public Appointments Committee. The Government stands ready, if invited, to discuss any reform proposals with the Parliament.

Stephen Kerr (Conservative, Central Scotland)

The minister did not answer my question. I asked whether there was time for a debate. The minister will be aware that there is a clear desire and appetite from members across the chamber to see our Parliament reformed. It is also apparent that there is scope for common ground on reform among colleagues in all parties in this Parliament. We all want the Scottish Parliament to effectively fulfil its appointed role in its function as a legislature and in its day-to-day scrutiny of the Executive.

Therefore, will the minister, on behalf of the Government, confirm to members that he and his ministerial colleagues will be supportive of such reforms that might be initiated by the Standards, Procedures and Public Appointments Committee and engage positively with all interested parties, including my colleague Donald Cameron, to secure such reforms as might be determined to be needed to enable the Parliament to be effective in carrying out the business of the people of Scotland?

George Adam (Scottish National Party, Paisley)

As always, Mr Kerr and I seem to have a communication problem. I will say it again: the Scottish Government stands ready, if invited, to discuss any reform proposals with the Parliament. As always, he mentions Donald Cameron. Once again, when Donald Cameron asked about that in the chamber on 18 January, I said that, although I did not agree with Mr Cameron’s summation of the situation, I was happy to meet him to discuss it further. That meeting is scheduled for 2 March. As always, the Government is willing to engage with anyone.

The Deputy Presiding Officer

Martin Whitfield has a brief supplementary question.

Martin Whitfield (Labour, South Scotland)

It is right that decisions about parliamentary reform sit in this chamber and with the Parliament instead of with the Scottish Government. However, would the Scottish Government co-operate with committees and the Parliament on any inquiries relating to reform of parliamentary procedure?

George Adam (Scottish National Party, Paisley)

As always, I am happy to engage with the Standards, Procedures and Public Appointments Committee. I have done that on numerous occasions, including with Mr Whitfield as the convener. We will happily get involved in any future work that the committee should bring to us. As with any other member of this Parliament, we will look at it and take it from there.

The Deputy Presiding Officer

Bill Kidd has a brief supplementary question.

Bill Kidd (Scottish National Party, Glasgow Anniesland)

The minister will be aware of the Delegated Powers and Law Reform Committee’s report on the Retained EU Law (Revocation and Reform) Bill, in which concerns were raised about the amount of time that is available for the Scottish Parliament to scrutinise elements of the bill. Does the minister have any concerns about the time that is available to give adequate scrutiny to the bill?

The Deputy Presiding Officer

Please be very brief, minister.

George Adam (Scottish National Party, Paisley)

The member will be aware that we discussed that question at the DPLR committee meeting yesterday. The Scottish Government is taking forward work to identify retained European Union law so that it can be preserved before the end of 2023. At this stage, it is too early to know what the impact will be on the wider legislative programme, but that is being kept under review.

Covid-19 Recovery Strategy (Support for Students)

Katy (Labour, West Scotland)

8. Presiding Officer, I apologise that I did not arrive until portfolio question time was starting.

To ask the Scottish Government what steps it is taking through its Covid recovery strategy to support students. (S6O-01875)

John Swinney (Scottish National Party, Perthshire North)

The Covid recovery strategy is focused on reducing systemic inequalities, tackling poverty and supporting the people who were most affected during the pandemic. That includes a range of actions to support and enhance the wellbeing of all children and young people, including through investing a further £45 million in our young person’s guarantee in 2022-23. Further detail on the support that is being provided to students is set out in our coronavirus education recovery strategy, which describes a range of advice, guidance and funding that is provided with regard to mental health, wellbeing and tackling digital poverty.

Katy (Labour, West Scotland)

In the Covid-19 recovery strategy, the Scottish Government states that it recognises the significant cost of rent for many households. A recent report commissioned by the National Union of Students has found that rents for student accommodation increased by 34 per cent between 2018 and 2021. Will the cabinet secretary commit to reinstating the rent freeze for student accommodation until a permanent system of rent controls is put in place?

John Swinney (Scottish National Party, Perthshire North)

I certainly cannot commit to that this afternoon. That is quite a big undertaking to give. I will take away the issues that Katy Clark has raised. The Government has taken measures, which have been properly considered by the Parliament, to apply a freeze on rents. As Katy Clark will know, legislative provisions are under way. I will certainly take away the point that she has raised and ensure that it is considered by the relevant ministers.

Stephanie Callaghan (Scottish National Party, Uddingston and Bellshill)

I welcome the support set out for students during the cost of living crisis, which I know is weighing heavily on their minds. Will the Deputy First Minister provide an update on the mental health and wellbeing support that is available to students?

John Swinney (Scottish National Party, Perthshire North)

We have supported the National Union of Students’ think positive initiative, which signposts students to places where they can get help. Through student mental health agreements, student associations and institutions can work jointly on mental health practices.

There is work under way on the strategic delivery of that work, which is being taken forward by a working group chaired by the Minister for Higher Education and Further Education, Youth Employment and Training, and which is determined to ensure that we have the necessary steps in place to protect the mental wellbeing of young people and students.

Finance and the Economy

The Deputy Presiding Officer

The next portfolio is finance and the economy. I remind members that questions 6 and 7 are grouped together and that I will take supplementaries on those questions after both have been answered. I make the usual request that, if somebody wants to ask a supplementary question, they should press their request-to-speak button during the relevant question. Again, there is a lot of interest in this portfolio, so I would appreciate the same brevity in questions and responses.

Superfast Broadband (Update)

Willie Rennie (Liberal Democrat, North East Fife)

1. To ask the Scottish Government whether it will provide an update on its commitment to deliver superfast broadband to 100 per cent of premises in Scotland by 2021. (S6O-01876)

Ivan McKee (Scottish National Party, Glasgow Provan)

As at 31 December 2021, all homes and business across Scotland had the ability to access a superfast broadband connection through one of the three strands of activity that make up the R100—reaching 100 per cent—

programme: the £600 million R100 contracts, the demand-led R100 Scottish broadband voucher scheme and commercial coverage.

By the end of December 2022, the R100 contracts had built connections to more than 16,600 properties across the length and breadth of Scotland, with more than 2,800 connections also delivered through R100 vouchers.

Willie Rennie (Liberal Democrat, North East Fife)

The minister must think that I am zipped up the back if he expects me to believe that answer. It was not delivered by the end of 2021. I personally do not have superfast broadband in my house—and I am not alone. Hundreds of thousands of other people across Scotland do not have superfast broadband either, and therefore it is not at 100 per cent.

A new freedom of information release found that it will not be delivered until March 2028—almost seven years late. Why is the minister insisting that he has met the election promise when he clearly has not?

Ivan McKee (Scottish National Party, Glasgow Provan)

As I indicated in my previous answer, the voucher scheme was put in place to ensure that anyone who wanted to connect as at that date was able to do so. We continue to roll out the programme as planned, with a commitment of £600 million to support that. We have to bear in mind, of course, that telecoms provision

is a reserved matter, but the Scottish Government recognises its importance to communities, businesses and families across Scotland—hence our commitment to spend that additional £600 million to roll out the programme.

Jenni Minto (Scottish National Party, Argyll and Bute)

Can the minister provide any update regarding the Scottish Government’s latest engagement with the United Kingdom Government regarding the funding available to deliver its project gigabit commitment?

Ivan McKee (Scottish National Party, Glasgow Provan)

The Scottish Government continues to work closely with

the United Kingdom Government to shape what project gigabit will look like in Scotland. To date, we have secured £28.5 million of funding, which is being used to enhance and extend R100 contract coverage across rural Scotland.

The UK Government has not provided a Scotland-wide allocation of project gigabit funding that would allow things to move forward at maximum pace. We should also recognise that that £28.5 million is out of a total of £1.2 billion confirmed by the UK Government, which is out of a total of £5 billion that it originally committed to that programme.

In the weeks ahead, we will engage with broadband infrastructure providers to understand their current and future gigabit delivery plans and to gauge their level of interest in bidding for new broadband contracts in Scotland. It is vital that the UK Government commits a level of funding that will extend gigabit connectivity to Scotland’s rural and island communities, as well as urban and semi-urban areas, to ensure that no one is left behind.

Jamie Halcro Johnston (Conservative, Highlands and Islands)

In the past week or so, a damaged cable led to broadband outages in some communities in Orkney and the north of Caithness, and that follows damage to two cables in October, which left shortages in Shetland. What discussions are taking place with network providers to reduce the potential for disruption and to increase network resilience?

Ivan McKee (Scottish National Party, Glasgow Provan)

We are engaged in discussions to ensure that there is as much resilience as possible in the system and that such outages are protected against. Clearly, there is the possibility that freak incidents will occur, but we have put in place subsea cables to extend coverage and the work that is being done on connectivity and ensuring that there is resilience across the system will continue.

Greater Glasgow and Clyde (Investment)

Pauline McNeill (Labour, Glasgow)

2. To ask the Scottish Government what assessment it has made of the impact of investment levels on the status of the greater Glasgow and Clyde area, including how this compares to similar city regions across the United Kingdom. (S6O-01877)

Richard Lochhead (Scottish National Party, Moray)

As part of the consultation process for the national strategy for economic transformation, the Scottish Government received information on every region in Scotland. That information shows a varied landscape with a number of economic strengths, from clean growth to aerospace.

As Pauline McNeill will be aware, the Scottish Government is investing £500 million in the Glasgow city region deal, which aims to lever in an estimated £3.3 billion of private sector investment to support the delivery of projects, to work with 4,000 individuals and to help at least 600 employment and support allowance claimants into sustained work. We are committed to spreading the benefits of economic growth across the Glasgow city region and to ensuring that deprived areas benefit from that growth.

Pauline McNeill (Labour, Glasgow)

I put on record the fact that I welcome that investment. However, the Scottish Government does not seem to recognise that Glasgow has an economy that is underperforming in relation to the European average for growth and productivity, and that it has a smaller voice in the British and Scottish growth debates than a city of its stature—

the largest city in Scotland—should have.

Yesterday, I raised the fact that the decision not to accept the Clyde green freeport bid was an extremely significant blow to Glasgow, which I do not think has been recognised by the Scottish Government. Stuart Patrick, chief executive of the Glasgow Chamber of Commerce, said:

“Overlooking Scotland’s entire west coast risks making both the UK Government’s Levelling Up strategy and delivery of the Scottish Government’s commitment to a Clyde Mission extremely challenging.”

What does the minister have to say in response? What plans does the Scottish Government have to ensure that Glasgow, as one of the big four UK cities outside London and the most locked-down city in the whole of the UK during the pandemic, is not left behind?

Richard Lochhead (Scottish National Party, Moray)

I assure the member that the Scottish Government absolutely supports Glasgow city’s, and the wider region’s, aspirations. In looking at some of the funding awards that have been made in the past few weeks alone, I see that Glasgow—including the Govan graving docks, which have lain empty for 40 years—has benefited from the vacant and derelict land investment programme. The Government’s recycling improvement fund has made awards to some exciting projects in Glasgow. In addition, the regeneration capital grant fund has made awards to projects in Glasgow, including for the transformation of a former pipe factory into a community centre and creative hub for young people.

That is to name just a few of the awards that have gone to Glasgow and the surrounding region in the past few weeks alone. That is in contrast to what we have seen from the UK Government, with the levelling up fund being an absolute damp squib and failing Glasgow, the wider city region and the rest of Scotland.

I assure Pauline McNeill that the Scottish Government will continue to support Glasgow’s aspirations.

John Mason (Scottish National Party, Glasgow Shettleston)

The minister mentioned the city deal. Can he say more about the city deal? Does it compensate for the levelling up money that we lost?

Richard Lochhead (Scottish National Party, Moray)

As John Mason knows, the deal empowers Glasgow and the region to identify, manage and deliver a programme of investment to stimulate economic growth and create jobs in the area. That funding is issued twice per year, using the agreed governance arrangements, whereby funding is distributed to projects according to the wishes of all eight local authorities across the region. One such example is the bridge over the M8, which is due to open soon and which forms an active travel route linking Sighthill and the city centre. It is part of the £0.25 billion regeneration project for Sighthill, which will improve the economic flow between all those areas.

That is just one example.

As to whether the city deal compensates for

the levelling up money that was lost, as I said yesterday to Parliament, many parts of Scotland, including areas that are most in need, such as many areas of Glasgow, have been completely ignored and have not received a penny of the £3.8 billion that the UK Government has allocated for levelling up across the UK.

The Deputy Presiding Officer

Question 3 was not lodged.

Business Activity

Sandesh Gulhane (Conservative, Glasgow)

4. To ask the Scottish Government what it is doing to encourage business activity in Scotland. (S6O-01879)

Ivan McKee (Scottish National Party, Glasgow Provan)

We know that businesses in Scotland are struggling because of Brexit and the Tory Government’s economic mismanagement, and that is why the Scottish Government is providing, through our limited levers, immediate support, including the lowest non-domestic rates poundage in the United Kingdom. [

Interruption

.]

At the same time, we are delivering our national strategy for economic transformation to achieve our long-term ambitions for a stronger, fairer and greener economy. The strategy’s programmes focus on stimulating entrepreneurship, opening new markets, increasing productivity, developing the skills that we need, and ensuring fairer and more equal economic opportunities. We are working closely with delivery partners, businesses, the third sector and trade unions to successfully implement the strategy.

Sandesh Gulhane (Conservative, Glasgow)

Businesses across Scotland have raised significant concerns regarding the Scottish National Party-Green Government’s roll-out of a deposit return scheme, calling it “completely unworkable”, “negative” and “complicated”. It will put jobs at risk, add a massive burden to businesses at a time when they need support, and discourage business. Stakeholders are clear that the plans are poorly thought through, and the Scottish Government is not giving enough attention to those concerns.

Will the Scottish Government listen to businesses and commit to launching the scheme only once businesses have had the answers that they desperately need?

Ivan McKee (Scottish National Party, Glasgow Provan)

We are very conscious of the need to engage with businesses, which is why we have such an extensive programme of engaging with, listening to and responding to the needs of business. It is also why I am chairing the regulatory joint task force, which was set up by the Deputy First Minister. In the past few weeks, the task force has had two meetings, and it is working closely with the business community to assess the impact of regulations, make sure that business regulation impact assessments are doing their job and ensure that we address the impact of different regulations on the business community.

We are focused on listening to and working with business to make sure that the regulations that my colleague Lorna Slater is taking forward on the deposit return scheme, and all other regulations that the Government introduces that impact on business, are properly assessed. We listen to businesses to make sure that their views and concerns about those regulations are taken into account.

The Deputy Presiding Officer

I remind colleagues that we listen with respect to not only questions but the answers that are given to those questions.

Fiona Hyslop (Scottish National Party, Linlithgow)

On Friday, many of us took part in the successful business in Parliament event, which was hosted jointly by the Economy and Fair Work Committee and the Scottish Government. Will the minister join me in thanking Parliament and Government staff who made it possible for the 250 delegates from business and MSPs to come together to have frank but positive discussions about the issues faced by businesses across Scotland?

Ivan McKee (Scottish National Party, Glasgow Provan)

I took part in the business in Parliament conference myself and was hugely impressed by the contributions that were made by a wide range of businesses in the plenary sessions and the workshop in which I took part. I thank the Parliament staff and others who were involved in putting on the event.

The conference is one of a range of events that the Government takes part in to ensure that we are working with, listening to and reflecting on the concerns of business. We are hearing from a wide range of businesses across all sectors in Scotland to make sure that we work together to build and strengthen Scotland’s economy.

United Kingdom Economy (International Monetary Fund Analysis)

Jim Fairlie (Scottish National Party, Perthshire South and Kinross-shire)

5. To ask the Scottish Government what assessment it has made of the potential impact in Scotland of the recent analysis by the International Monetary Fund, which found that the United Kingdom economy is set to shrink by 0.6 per cent in 2023. (S6O-01880)

Richard Lochhead (Scottish National Party, Moray)

As was set out in the Scottish Government’s recent monthly economic brief, the Scottish economy is facing a challenging outlook. As the IMF projection shows, a lot of that challenge is down to the UK Government’s economic mismanagement.

The IMF also highlights that labour market shortages are affecting Scotland and the UK more than other countries. They have been made worse by Brexit, which continues to hold back our economy and make it harder for Scotland to deliver fairer and more sustainable economic growth.

Jim Fairlie (Scottish National Party, Perthshire South and Kinross-shire)

It is now more than three years since the UK left the European Union. Despite all the promises that Brexit would bring in a new era of prosperity for all, it is leading to long-term damage to the Scottish economy, and the decision is contributing to the UK’s becoming the poor man of Europe.

Now that Labour has become the new champion of making Brexit work, does the cabinet secretary agree that the only way to recover from the damage of leaving the European Union and protect Scotland’s future is for Scotland to become an independent country?

Richard Lochhead (Scottish National Party, Moray)

Unsurprisingly, I agree with the member. The evidence is that Brexit has been disastrous for Scotland. For instance, the Scottish Government’s analysis shows that Scotland’s trade in goods with the EU was 12 per cent lower in 2021 because of Brexit.

There have been many other warnings.

Indeed, the combination of the United Kingdom Tory Government’s austerity agenda and Brexit must amount to the two gravest economic errors of our lifetime. They are imposing enormous damage on the Scottish economy and our people’s life chances. When it comes to helping to repair the damage, it is indeed the case that if Scotland was independent we would be able to rejoin Europe and gain the economic benefits from doing so.

Local Government Financial Settlement (Convention of Scottish Local Authorities Representations)

Neil Bibby (Labour, West Scotland)

6. To ask the Scottish Government what representations it has had from COSLA regarding the local government financial settlement. (S6O-01881)

John Swinney (Scottish National Party, Perthshire North)

The Scottish Government has received a number of representations from COSLA regarding the local government finance settlement. Ministers and officials regularly meet representatives from COSLA and individual local authorities to discuss a range of issues, as part of our commitment to working in partnership with local government to improve outcomes for the people of Scotland.

Neil Bibby (Labour, West Scotland)

The Scottish Government has claimed that the budget makes £570 million more in resources available to councils, but I say to the Deputy First Minister that that is not quite true, is it? COSLA says that, when ring fencing and directed spend are accounted for, the budget increases council spending by just £71 million in cash terms for Scotland as a whole.

The Scottish Parliament information centre tells me that the COSLA figure equates to £304 million in real-terms cuts. The Fraser of Allander Institute says that there is a real-terms cut. The Institute for Fiscal Studies says that there is a real-terms cut. Even Scottish National Party councillors are not buying the Government’s figures. Will the Deputy First Minister drop the spin, face the truth and admit that this is a budget for more cuts, closures and strikes across Scotland?

John Swinney (Scottish National Party, Perthshire North)

The Government

has allocated £570 million more to local government for the next financial year compared to this financial year—budget bill to budget bill. That is the fact, and that is the reality of the budget uplift that has taken place.

In the resource spending review, the position for local government was presented as being flat cash from this financial year to the next. We have changed that. We increased the number by £570 million, to enable local authorities, as best we can within the resources that are available to us, to withstand the challenges that we all face around inflation.

Mr Bibby knows how the budget system works. There is a total funding envelope available. It has been allocated in full to portfolios. If Mr Bibby wishes to change that and allocate more money to local government, he has to do the decent, straightforward and honest thing and tell us where the money will come from. He should not come to the Parliament and posture; he should tell us where the money will come from.

Local Authorities (Budget Settlement)

Murdo Fraser (Conservative, Mid Scotland and Fife)

7. To ask the Scottish Government how its budget settlement for local authorities will support the future delivery of quality public services. (S6O-01882)

John Swinney (Scottish National Party, Perthshire North)

In 2023-24, local authorities will receive funding through the local government finance settlement of £13.2 billion. Local authorities also have a range of revenue raising powers that are not available to other public services.

The impact of the settlement on public services will depend on how local authorities allocate the total resources that are available to them and the level of service that they then provide. Although local authorities are responsible for setting their own budgets, the total funding that is provided by the Scottish Government will increase by more than £570 million in 2023-24 compared with the 2022-23 budget.

Murdo Fraser (Conservative, Mid Scotland and Fife)

The cabinet secretary claims, again, that more money is going into local government, but in the real world, councils are having to make savage cuts. That includes Scottish National Party-run councils, whose leaders are in revolt. Just this morning, Perth and Kinross Council—a council with which Mr Swinney is very familiar—agreed that its SNP leader should write to the cabinet secretary to express extreme displeasure and frustration at being threatened with sanctions rather than given adequate funding.

Members on the Conservative benches have been clear that Mr Swinney should scrap the national care service and redirect that money into local government. If he is not going to do that, where does he think that the cuts should fall? If not on education, should they fall on libraries, leisure services, arts and culture, the environment or support for vulnerable families? Where should the cuts fall?

John Swinney (Scottish National Party, Perthshire North)

Murdo Fraser does not support the increases in tax that I have announced in the budget, so before he comes to the chamber and tries to argue for any reallocation of money, there is a big, gaping, stonking black hole in his argument, which is his unwillingness to take the hard decisions that I have taken on tax. I have become accustomed to Mr Fraser’s posturing over many years, but, having wanted us to follow the Truss mini-budget that destroyed the public finances, he was then not prepared to take hard decisions on tax. Forgive me, Presiding Officer, but I will pay no attention to the Conservative Party’s critique of the budget that I have presented.

The Deputy Presiding Officer

There are a number of supplementary questions. I will try to get through as many as possible, but they will need to be brief, as will the responses.

Bill Kidd (Scottish National Party, Glasgow Anniesland)

More than a decade of Westminster austerity has had a substantial impact on the Scottish block grant and the resources available to fund public services in Scotland. Can the cabinet secretary provide further information on what assessment has been made of the impact that that austerity has had on Scottish Government funding and how the levels of revenue funding provided to local authorities in Scotland compare?

John Swinney (Scottish National Party, Perthshire North)

Since the Conservative Government came into office in 2010-11, average real-terms cuts have been more than 5 per cent. That equates to a loss of £18 billion to Scottish Government budgets over that period, and there will be consequential effects on local government into the bargain.

Mr Kidd’s point is important. When the challenges that we face on hyperinflation, which, among other things, has been fuelled by the actions of the Conservative Government and its mismanagement of the mini-budget in September, are built on to the effects of austerity, they place real and enduring pressure on our public services and finances.

Daniel Johnson (Labour, Edinburgh Southern)

The Convention of Scottish Local Authorities estimates that road spending has fallen by a third, and there is a £1.7 billion repair backlog. Since 2010, spend on children’s play parks has fallen by 38 per cent. In libraries, spending on new books has fallen from £1.79 to 92p per person since 2007. What is the cabinet secretary’s assessment of this budget settlement on those services, and has the Scottish Government carried out an assessment of the impact on local services?

John Swinney (Scottish National Party, Perthshire North)

I will make two points. First, I think that Mr Johnson would accept that a decade of Conservative Government austerity has put cumulative pressure on Scotland’s public finances. I accept that, and I would have thought that he would have accepted it into the bargain.

Secondly, in the context of a very challenging fiscal environment, with all the issues and difficulties that we have faced, the Government has increased the resources available to local government by more than £570 million. That cash increase is there for local authorities to deploy in the appropriate way, as they see fit, to meet the challenges in their local areas.

Deposit Return Scheme (Repayment of Investment)

Brian Whittle (Conservative, South Scotland)

8. To ask the Scottish Government what discussions the finance secretary has had with the Scottish National Investment Bank and the Bank of Scotland regarding any impact of the repayment terms of the investment in Circularity Scotland in May 2022 on the timetable for the launch of the deposit return scheme. (S6O-01883)

Lorna Slater (Green, Lothian)

Scottish ministers meet regularly with the chair and senior leadership team of the bank. As was agreed at its creation, the bank has operational independence, so it is not the role of Scottish ministers to intervene in any individual investment process.

As is set out in the regulations, Scotland’s ambitious deposit return scheme will launch on 16 August this year. It will be a major part of our efforts to reduce littering, cut emissions and build a more circular economy.

Brian Whittle (Conservative, South Scotland)

When a bank gives a business loan, there will always be an investment memorandum that dictates when the loan will be paid back and the interest that will be paid as part of the return on investment; furthermore, there will be penalty clauses for any late payment. Does the minister really suggest that the bank’s loans are unique in that there is no timetable for repayment and that, therefore, there is no impact on the timetable for the launch of the DRS? My real question is this: is the decision regarding the launch financial rather than being based on the business considerations of the businesses that will be impacted by the scheme?

Lorna Slater (Green, Lothian)

As I noted in my first answer, the bank’s investment decisions are independent of Scottish ministers, and ministers do not intervene in any individual investment process.

Our deposit return scheme will launch on 16 August this year, as was agreed by the Parliament when the go-live date was announced in December 2021.

Stuart McMillan (Scottish National Party, Greenock and Inverclyde)

I understand that the United Kingdom Government is yet to reach a decision on how VAT will be applied to deposits as part of the DRS. Can the minister provide an update on the Scottish Government’s latest engagement with the UK Government regarding that issue?

Lorna Slater (Green, Lothian)

We know how important it is for business to have clarity on the VAT on deposits. We are working closely with the UK Government to resolve that issue, and we are seeking action to minimise the risk to the Scottish scheme. I have met UK ministers on a number of occasions on the issue and have asked that it be resolved by July 2022 at the latest. As the issue was still unresolved as of last week, the Deputy First Minister wrote to the Chancellor of the Exchequer to request that a decision be communicated this week at the latest, and that is what we are now anticipating.

Ultimately, I believe that all tax powers, including those relating to VAT, should sit with the Scottish Parliament so that the decisions that affect Scotland’s businesses and people are made here, in Scotland.

The Deputy Presiding Officer

That concludes portfolio question time. There will be a brief pause before we move to the next item of business.

A9 Dualling

Annabelle Ewing (Scottish National Party, Cowdenbeath)

The next item of business is a statement by Jenny Gilruth on A9 dualling update. The minister will take questions at the end of her statement, so there should be no interruptions or interventions.

Jenny Gilruth (Scottish National Party, Mid Fife and Glenrothes)

I welcome the opportunity to provide an update to Parliament on the A9 dualling programme.

The A9 cuts through the heart of Scotland—some call it the spine of Scotland—linking lowland with highland. It is a vital route for the people and businesses of the north of the country and it is a road on which we have witnessed a devastating increase in fatalities in recent times.

Before Christmas, I committed additional investment of £5 million from the Government to improve short-term safety measures on the A9, but I am very clear that the main route to improving road safety will be in the full completion of the dualling programme between Perth and Inverness. That has been a long-standing commitment of this Government, and we remain absolutely committed to fulfilling it.

I recognise the significant public and parliamentary interest in the progress of the route, championed by organisations such as the A9 dual action group, representatives of which I met very recently, and by members of the Parliament, whom I have met on a number of occasions in recent times to discuss the A9.

As MSPs will know, we have recently been actively progressing the procurement of the next section of the programme, between Tomatin and Moy. That process has now concluded, and I take the opportunity today to advise members of the outcome and to provide an update on the remaining sections of the programme.

Before I turn to those matters, it might be helpful to reflect on both the scale of the programme and the progress that has been made thus far. The programme comprises 11 projects, which together will provide approximately 80 miles of new dual carriageway between Perth and Inverness. With an estimated cost of £3 billion at 2008 prices, it is one of the largest infrastructure programmes ever undertaken in Scotland.

Two of the 11 projects, providing more than 10 miles of new dual carriageway, are complete and open to use. Those are the Kincraig to Dalraddy and Luncarty to Pass of Birnam sections, which opened in September 2017 and August 2021 respectively.

Ministerial decisions to complete the statutory process have been confirmed for eight of the nine remaining projects. That covers more than 92 per cent of the length to be dualled. For the one remaining section, we are continuing to progress the Pass of Birnam to Tay crossing project and to identify a preferred route option following an innovative co-creative process with the local community. An announcement on the preferred route there will be made this spring.

Our investment of more than £430 million to date has meant that much has already been achieved. All of that has been done alongside the successful delivery of a number of other significant investments by the Government, including the Queensferry crossing, the Aberdeen western peripheral route and the M8 motorway improvements, delivering tangible benefits to lives across the country on a daily basis. Although much is still to be done, this Government is absolutely committed to completing the A9 dualling programme.

Separately, as was previously mentioned, in recognition of the immediate road safety concerns following fatal accidents that occurred on the route in the second half of 2022, I announced an investment of approximately £5 million in additional road safety measures for the A9 back in December. I am pleased to confirm that those safety measures have now commenced and are progressing well, as was confirmed to me by Bear Scotland at the A9 safety group meeting that was held last week in Inverness.

That work includes enhancements to signing and road markings, initially between Birnam and Dalguise, and the installation of electronic signs to display safety messages between Perth and Inverness. Furthermore, a road safety campaign targeting driver fatigue will begin next week, on 13 February, and preparations for a “drive on the left” campaign are well under way ahead of a launch this Easter. Next month, I will convene a stakeholder summit with the car hire companies that serve our main airports, to discuss further work that we can undertake with the sector to improve foreign drivers’ understanding of the A9.

My sympathies continue to be with everyone who has lost a loved one on Scotland’s roads. One life lost on any of Scotland’s roads is, of course, one too many. As a Government, it was imperative that we responded to the devastating increase in fatalities on the A9, and I am hopeful that those more immediate measures will help to support a reduction in road traffic accidents.

On the outcome of the procurement of the Tomatin to Moy project, three bidders were invited to participate in a procurement exercise back in December 2021, with final tenders required to be submitted by October of last year. That coincided with external factors including the pandemic, disruption caused by Brexit, and the war in Ukraine. The inflationary impacts of all of those factors impacted significantly on the construction market.

Unfortunately, the final return yielded only one tender submission. The anticipated cost of the construction contract was £115 million. Following careful consideration of the tender, the price of which was significantly higher than expected, even allowing for the real-world impacts of the volatile economy, ministers have concluded that an award of the contract at this time would not represent best value for the taxpayer. At any time, but particularly in the current climate, protecting public finances is an essential part of responsible government.

Members will appreciate that, due to commercial confidentiality, it would be inappropriate for me to provide any further details of that bid, but I make clear our firm intention to retender for Tomatin to Moy at pace and with some urgency. I can confirm that the tenderer concerned has been informed of the decision in respect of the procurement.

I fully appreciate that this will be disappointing news for many people. However, I want to make it absolutely clear to members in the chamber, and to the communities and businesses served by the A9 between Perth and Inverness, that the Scottish Government’s commitment to dualling the section between Tomatin and Moy remains absolute.

It has been a difficult decision to make, but we believe that it is the only responsible one to take, given the circumstances. I reassure members that Transport Scotland is already taking the necessary preparatory steps for the retendering of the Tomatin to Moy project. Work has begun to update the contract terms, and work will continue on preparations for the new procurement for Tomatin to Moy with the firm aim of achieving a contract award before the end of this year.

At the end of last year, I invited members of the Scottish Parliament to meet Transport Scotland and wider stakeholders to discuss the range of short-term proposals for investment in the A9, specifically in relation to the increase in fatalities that we have seen on the route in recent times. To that end, and in a similar spirit, I propose that, soon after the retendering process commences, I will convene a meeting with interested MSPs, Transport Scotland and relevant stakeholders to discuss the next steps. MSPs should have a letter from me this afternoon about that.

It is imperative that MSPs are engaged in that work, and I recognise the rightful strength of constituency interest in that regard. As part of the retendering process, Transport Scotland will engage with representatives of the construction industry, including the Civil Engineering Contractors Association, on how elements of its standard terms and conditions for such projects might be modified to encourage more bidders to participate in future. We also need to recognise, however, that the construction market has changed substantially in recent years. We very much want to work with the supply chain while securing a good deal for the Scottish taxpayer.

Undoubtedly, the delivery of the overall A9 dualling programme has been impacted by a number of external factors. Although good progress has been made in securing the statutory consents, as for many other construction projects across the world, progress has been significantly disrupted by the pandemic. In addition, I do not need to remind members that the United Kingdom economic climate has been extremely volatile in recent times, particularly in the immediate aftermath of the UK Government’s mini-budget in September 2022.

Members will also be aware that Transport Scotland has been assessing the most suitable procurement options for the remaining sections of the A9 dualling programme. Following the principles of the Scottish public finance manual, that work has included consideration of whether procurement should be on the basis of a series of capital-funded design and build contracts similar to those used for the recently completed Luncarty to Pass of Birnam project or whether a smaller number of larger-scale, resource-funded public-private partnership contracts similar to those used on the Aberdeen western peripheral route should be used instead.

Due to the recent economic volatility, including the impact on borrowing costs of the UK Government’s mini-budget, it has been necessary to look at the impact of market changes on the available procurement options. In the light of the outcome of the Tomatin to Moy procurement process, that assessment must now consider the potential cost implications of any changes to the terms and conditions in our roads contracts.

Members will know that the original completion date for the dualling of the A9 was scheduled to be 2025. As MSPs will now understand, that timescale is simply no longer achievable. However, I will set out a revised timescale as soon as possible, seeking to minimise delay as far as possible. It is true that the target date that was originally set was always an ambitious challenge. It was also reliant on the timely and positive outcome of a range of factors such as the completion of public and stakeholder consultation, statutory approval processes, market capacity, supply chain availability and the availability of funding—all of which have been significantly impacted by the events that I outlined earlier. That has made the 2025 deadline simply unachievable.

I appreciate that members will want to know what the new target date for the completion of the A9 dualling programme might be, as do I. As I previously stated, Transport Scotland is urgently considering a range of different options, to provide ministers with advice on the most efficient way to dual the remaining sections. I expect to have that advice by the autumn of this year, at which time I will update Parliament and put forward a renewed timescale for completion.

I reiterate the Government’s unwavering commitment to delivering the benefits of the completed A9 dualling programme to the people of Scotland. We will support that commitment by continuing the work to obtain the outstanding statutory consent for the Pass of Birnam to Tay crossing project and by completing the required land acquisition as soon as possible. We will also urgently engage with industry partners, working together to progress the Tomatin to Moy project in a way that offers a good deal for Scottish taxpayers.

The Government committed to dualling the A9 for a good reason. Dualling of the route will improve connectivity between the central belt and the Highlands of Scotland, deliver better opportunities for tourism and business and fundamentally improve road safety on the A9, as well as the lives of people who live in communities alongside the route. The Scottish Government’s resolute commitment to full dualling of the A9 remains absolute. I look forward to continued engagement with members as we refocus our efforts to deliver the outstanding sections of the road in as timely and efficient a manner as possible.

The Deputy Presiding Officer

The minister will now take questions on the issues that she has raised in her statement. I intend to allow around 20 minutes for questions, after which we will move on to the next item of business. I ask members who wish to ask a question to press their request-to-speak buttons.

Murdo Fraser (Conservative, Mid Scotland and Fife)

I welcome the temporary road safety measures that are currently being implemented. However, communities along the A9 in Perthshire and the Highlands have been waiting for more than a decade for the Government to fulfil its commitment to dualling the A9 in its entirety from Perth to Inverness. In that time, barely 10 miles have been completed out of a total of 80 miles—just one eighth of the total project. Today, we might have hoped for some positive news from the minister or some detail on the timetable for the long-delayed completion. Instead, all we have is more bad news, with a further delay to the

Tomatin to Moy section. The minister could tell us nothing about what the progress will be on the remaining sections of the road. No details, no timescales and no hope—just empty words, repeated over and over again, about the Government’s unwavering commitment.

Actions speak louder than words. Last year, 12 people lost their lives on single-carriageway sections of the A9. More people will die this year, next year and the year after as the Scottish National Party promise is not delivered. Can the minister give us any indication of when the long-standing commitment will be met and when the long-delayed and vital road safety project will be completed?

Jenny Gilruth (Scottish National Party, Mid Fife and Glenrothes)

I recognise the strength of interest from members, and particularly Mr Fraser, who raises the issue of the A9 with the cabinet secretary and me on a fairly regular basis, noting his own interest in his region. I recognise that other members from the area do likewise.

Fundamentally, the Government has faced a number

of challenges in recent times. Murdo Fraser might have heard the Deputy First Minister giving a response to a question from a member on the Conservative benches earlier this afternoon in which he set out some of the recent financial challenges that the Government has faced. First, there is the impact of the pandemic, which cannot be understated, particularly in relation to the construction industry across the piece—not just in relation to road building. Secondly, there have been inflationary impacts in relation to Ukraine and, layered on top of that, impacts from Mr Fraser’s colleagues down south in relation to the mini budget. All of that needs to be considered in its totality. That is why the work that Transport Scotland is undertaking to assess the market implications and determine where we can make the best progress in the quickest and most efficient way is hugely important.

I recognise some of the challenges here, and that is why, this afternoon, I have written to members to reassure them about the approach that I intend to take, working with members such as Mr Fraser.

It is worth reflecting on the fact that we have made progress in recent times. As I mentioned, we have invested £431 million in delivering the dualling programme. Of course, we need to adhere to statutory processes in relation to roads building, and that takes time. As the responsible minister, I would like to be able to move more quickly on this, but I recognise that there are processes that we need to adhere to in relation to road building.

More generally, I am keen to come back to the Parliament later this year with an update. The Tomatin to Moy section of the A9 has been challenging in ways that I do not think that ministers expected. It has been quite an unusual situation, as we have had only one tender in this instance. Therefore, we are moving forward at pace on the retendering of that specific section, and I will come back to the Parliament later in the year to set out the timeline that the member has asked for.

Rhoda Grant (Labour, Highlands and Islands)

This is a total betrayal of the Highlands. It is a broken promise—I wonder whether the Government ever intended to keep it.

The scale of the project is exactly the same as it was 16 years ago—sadly so, given the lack of progress and the lives that are being lost on that dangerous road.

This is an issue of the minister’s Government’s making. Had it even attempted to adhere to its own timescales, contracts would have been awarded by now. It is also shameful that, on the day that Volodymyr Zelensky is addressing the UK Parliament, SNP ministers are trying to blame the war in Ukraine for their failures to deliver a manifesto pledge from 2007.

Will the minister now come clean on the estimated timescale for dualling the A9 to Inverness? If she cannot answer that, can she at least give an indication of when the routes between Inverness and Dalwhinnie and between Perth and Ballinluig will be fully dualled? Further, will she now apologise to the people of the Highlands for this gross betrayal?

Jenny Gilruth (Scottish National Party, Mid Fife and Glenrothes)

I ask

Ms Grant

to reflect on some of the other investments that the Government is delivering in the region that she represents. Only last week, I opened Inverness airport station—a significant investment in the local area that will help to improve connectivity.

Ms Grant

mentioned the recent increase in the number of fatalities on the road. She attended the meeting that I convened with MSPs to look specifically at that issue and ask questions of BEAR Scotland and Police Scotland.

It is hugely important to recognise—as, I am sure, she does—the additional investment in the short-term measures that I announced at the end of last year, which will help to improve safety on the route.

Ms Grant has asked about a timetable. I think that I gave Mr Fraser an answer to his substantive point on that and said that work is being taken forward to consider the outstanding sections in their totality to determine the most efficient route for delivery. I will come back to the Parliament to update members on that later this year.

Emma Roddick (Scottish National Party, Highlands and Islands)

I am certain that correspondence is already coming in from constituents who are extremely disappointed and concerned about the news regarding the route from Tomatin to Moy. I share their disappointment. I cannot overstate how difficult it will be for locals to believe that this project will be carried out in the face of another delay, and I hope that the minister is able to provide an assurance that the Scottish Government remains committed not only to the project but to the people of the Highlands, amid continued accidents and fatalities on the road that it has committed to dualling. Can she give some more detail on how severely the restart of the procurement process could delay the dualling of that stretch of road, and can she say whether there is an issue with the Transport Scotland procurement process that makes it unattractive to bidders?

Jenny Gilruth (Scottish National Party, Mid Fife and Glenrothes)

I thank Emma Roddick for her question, and I want to give her the reassurance that she seeks in relation to the people of the Highlands. She was at the opening of Inverness airport station last week, so she knows how committed the Government is to continued investment in that part of the country. I very much recognise her interest in the route as a local MSP.

Transport Scotland’s design and build works contract has been successfully implemented for the past 20 years. Emma Roddick asked a question on the challenges with the process, which is all being considered in the round in relation to how we move forward at pace. If we need to change the way in which Transport Scotland approaches those projects, that will of course be looked at, because we need to make sure that we attract as much opportunity for investment as possible and that bidders are not put off by the process.

It is fair to say that, in recent years, there has been a decline in the numbers of tenderers, and we understand from industry contacts that that is largely due to the terms and conditions that are in our contract, including risk transfer. As I mentioned, Transport Scotland is reassessing that approach in the light of current market conditions. That work sits alongside changes that we might have to take in the future. We will look carefully at how we can get the best balance between achieving cost certainty and making our contract attractive to the market by looking at appropriate risk allocation—which is fundamentally important—as well as looking at the role of contracting parties and improving collaboration between Transport Scotland and the contractor.

Jamie Halcro Johnston (Conservative, Highlands and Islands)

The minister admitted today what we have all known for some time: the 2025 date will not be met. Communities along the A9 and road users have been kept in the dark on when and if the project will be completed.

Currently, how many years behind the original timescale is the project? When was the minister first told that the 2025 date would not be met?

Jenny Gilruth (Scottish National Party, Mid Fife and Glenrothes)

I thank Jamie Halcro Johnston for his questions.

Work on that is on-going, as I have said, and will report later in the year. I would like to come back to the Parliament later this year to give an update and reassurance in relation to the deadline.

Of course, we have to fulfil statutory processes when carrying out any major roads project in Scotland. It is clear that market conditions at the current time would not have allowed us to deliver the full dualling programme within the original timescale as previously set out, regardless of the delivery model that we choose. Therefore, we are looking at the optimal delivery programme to give certainty to the public. I recognise Jamie Halcro Johnston’s point in that regard. That is why, of course, I have been working closely with MSPs, including him, on how we can better work with communities to ensure that they understand the next steps for the programme. To that end, I have written to members this afternoon to invite them to engage with me and Transport Scotland on the next steps in the delivery of the project.

Fergus Ewing (Scottish National Party, Inverness and Nairn)

Today’s news will be met in the Highlands with shock, incredulity and anger. Why does Transport Scotland, unlike its counterpart south of the border, put all the risks of unforeseen costs on contractors? Surely, that makes—and has made—bidding less attractive. Nearly two years into this parliamentary session, why do we still not have a revised timetable to replace a deadline that every person in the Highlands knows was never going to be achieved?

Jenny Gilruth (Scottish National Party, Mid Fife and Glenrothes)

I thank Mr Ewing for his question and I recognise his strength of feeling about the A9, in particular, but also about the A96, which is in his constituency. We have met, in his constituency and in Parliament, to discuss the A9 and the A96 on a number of occasions. I am keen to work with the member on supporting his interests and those of other interested MSPs, because it is important that we get the next steps right.

I have outlined to members some of the challenges that we have faced in recent times. We had keen interest at the industry event days when the tender for Tomatin to Moy was first launched, and that was positive. At the beginning of the procurement process, three contractors pre-qualified for the bid. One of those withdrew early in the process, and another withdrew on the day before tenders were due for submission, which meant that only one tender was submitted. As I mentioned in response to Ms Roddick, Transport Scotland’s design and build works contract has been used for more than 20 years.

Some of Mr Ewing’s points are fair and they will all be considered in the wider work on how we move forward at pace on the totality of the sections of the route on which dualling remains outstanding.

As I mentioned in response to one of the Conservative members, there has been a decline in the number of tenders that are coming forward, so we need to look at the approach that we use in Transport Scotland. That will be addressed fundamentally as part of the wider advice that will come to ministers in the autumn, to ensure that, going forward, we have the best approach in Transport Scotland to attract the highest possible numbers of bids in order to deliver the programme as efficiently and timeously as possible.

Neil Bibby (Labour, West Scotland)

The minister has said several times today that the Government is absolutely committed to fully dualling the A9. Are the Greens fully committed to dualling the A9? Yes or no.

Jenny Gilruth (Scottish National Party, Mid Fife and Glenrothes)

I am not a Green Party minister.

Jim Fairlie (Scottish National Party, Perthshire South and Kinross-shire)

The A9 in my constituency is fully dualled, but the proposed Shinafoot junction has been an on-going concern for local folk for many years.

Following the minister’s visit to Shinafoot junction last year—for which I put my thanks on record—I was delighted to learn that the local authority had listened to local concerns and rejected a housing developer’s plan to put only an off-slip in place. A requirement for continuation of the housing development was that there would be both an on-slip and an off-slip.

Can the minister say anything about what she will do to ensure that she will, as the A9 developments continue, press to ensure that the incredibly dangerous junctions are given proper consideration to ensure that they are safe for people who are trying to navigate them?

Jenny Gilruth (Scottish National Party, Mid Fife and Glenrothes)

Jim Fairlie has raised a fair point. I met him and community representatives to discuss their concerns about the Shinafoot junction. As I noted at the time, the junction proposals were subject to on-going planning considerations by the local authority. My officials are still in dialogue with Perth and Kinross Council and local developers on the matter, to ensure that safety on the A9 is maintained at that location, and that access to and from the local community is improved, where possible.

It was really helpful to make a site visit with Mr Fairlie to see the challenge.

Of course, responsibility sits with developers to develop proposals for what is necessary to access their development. I am more than happy to continue that dialogue with Mr Fairlie, who will convey his constituents’ interests on the section of the route that he identified.

Liam McArthur (Liberal Democrat, Orkney Islands)

I thank the minister for advance sight of the statement. I think that Fergus Ewing and Emma Roddick have eloquently expressed the reaction that there will be among people in the Highlands to the announcement that the promise on dualling the A9 has, in effect, gone the same way as the promise on rolling out superfast broadband.

However, the A9 does not stop at Inverness. What reassurances can the minister offer to communities north of Inverness that the Government is committed to investments in improvements to safety on that part of the road?

Jenny Gilruth (Scottish National Party, Mid Fife and Glenrothes)

The Government is absolutely committed to continuing those investments. I reassure Liam McArthur, and observe more generally, that investment by the Government in road safety has been and will be increasing.

I have outlined some of the measures that have been taken. The short-term measures target the route between Perth and Inverness, but I recognise the other on-going challenges on the route north of Inverness. During the October recess, I met BEAR Scotland and Transport Scotland representatives to look at junction closures that will be happening north of Inverness. I am more than happy to write to the member with more detail on the financial investments that we have made in that part of the road.

Mark Ruskell (Green, Mid Scotland and Fife)

It is clear from speaking to Perthshire constituents who live alongside the A9 that acceleration of road safety is everyone’s top priority. The minister has helpfully outlined some of the urgent

safety measures that are being delivered. Can she update me on what consideration is being given to proposals to reduce speed limits on dangerous sections of the road, particularly the section between Birnam and Dunkeld?

Jenny Gilruth (Scottish National Party, Mid Fife and Glenrothes)

We have no plans to reduce speed limits on the A9. Proposals to amend speed limits will generally emerge as outcomes of the national speed management review, when it concludes. I am more than happy to give Mark Ruskell an update on that work, which is on-going but is set to report in the coming months. The national speed management review will provide us with the evidence base to consider changes to be made in the future.

John Mason (Scottish National Party, Glasgow Shettleston)

Inflation is clearly an issue in all this. The Finance and Public Administration Committee was told that the costs of some projects have gone up by 30 per cent, perhaps because of the war in Ukraine and Brexit. Is the minister concerned that we run the risk of tendering again and reaching the same outcomes of there being very little interest in tendering and a very high price?

Jenny Gilruth (Scottish National Party, Mid Fife and Glenrothes)

I recognise the challenge that John Mason has outlined. As I think I mentioned in response to another member, we originally had three bidders that pre-qualified for the bid, which is important to observe. One of those bidders withdrew early in the process and another contractor withdrew on the day before tenders were due for submission.

That resulted in only one tender being submitted. The outcome of that procurement competition was fairly unexpected and quite unusual. We have looked at some of the external factors that contributed to that.

Brexit and the situation in Ukraine—which John Mason mentioned—Covid-19 and, of course, the inflation that has been caused by the UK Government’s mini budget have all had broader impacts on the construction industry. The end of 2022 was an extremely challenging time for the construction sector more generally because, of course, we had peak inflation and additional market volatility.

Forecasts from the Building Cost Information Service show that the market is likely to settle in the coming months and years, and we anticipate that that will help us to get best value in the reprocurement exercise. Transport Scotland will, of course, engage with industry partners, including the Civil Engineering Contractors Association, to consider improvements that can be made to our design and build contracts—which have been the theme of some members’ questions today—to our contract delivery strategy and to the procurement mechanisms that we use.

Graham Simpson (Conservative, Central Scotland)

Jenny Gilruth has put the A9 on hold today. The so-called “unwavering commitment” to deliver is empty. There is no delivery programme. Why does she think firms are showing a lack of interest in working with the Scottish Government? The issue has been known about for years, and does not exist elsewhere in the UK. What is the problem?

Jenny Gilruth (Scottish National Party, Mid Fife and Glenrothes)

I am not sure that I agree with the premise of Mr Simpson’s question. It is worth my while to observe that Transport Scotland, through its market consultation, has been looking at feedback from the construction industry following the pandemic. It is important that we learn lessons from the pandemic and its implications for the construction industry more generally. That has given us an opportunity to look at, for example, closely sequencing construction work in a way that does not result in excessive disruption.

There have been several significant changes during the market consultation, including international impacts, which I have mentioned, and the challenging economic circumstances, which of course include the UK Government’s mini budget. It is important that Transport Scotland reassess its construction contracts more generally, in the light of that change. To answer Graham Simpson’s question, I note that we will look at how we can strike the best balance between achieving cost certainty and ensuring that our contracts are attractive to the market. That will be fundamentally important as we move forward with the retendering programme.

Gordon MacDonald (Scottish National Party, Edinburgh Pentlands)

The announcement will clearly come as a disappointment to communities and people who have campaigned on the issue over the years, but it is important to focus on exactly how this has happened. Can the minister confirm that the decision has been taken at a time of extreme financial pressures globally, that it is based on an assessment of value for money and that it is in line with HM Treasury’s “The Green Book” requirements, which ministers are required to follow.

Jenny Gilruth (Scottish National Party, Mid Fife and Glenrothes)

As I said, the outcome of the procurement competition was unexpected. We have touched on the external factors that contributed to that. The end of 2022 was a really challenging time at which to procure a major infrastructure project. We had peak inflation as well as market volatility more generally, which coincided with the end of the tender process.

Following a difficult and complex procurement procedure, Transport Scotland has decided not to award the contract for the Tomatin to Moy section under the current procurement competition. Having carefully reviewed the tender, we have concluded that it does not provide best value for the taxpayer at the current time. However, we will seek to secure continuous improvement in performance while looking to strike the appropriate balance between quality and cost. It is hugely important that our approach has regard to broader factors in relation to the economy, efficiency and effectiveness, and that it contributes to the achievement of sustainable development.

Gordon MacDonald’s question was well put; I am hopeful that the retendering process will deliver a range of options to allow us to move forward at pace.

Douglas Lumsden (Conservative, North East Scotland)

The delay to the A9 project will have a knock-on effect on other road projects. The A96 was meant to be fully dualled by 2030. Will that commitment be met?

Jenny Gilruth (Scottish National Party, Mid Fife and Glenrothes)

Douglas Lumsden will have received an invitation to meet the contractors who have carried out the substantive work in relation to the A96. I look forward to meeting the member and the contractors to talk about the review that has been carried out over the past year.

The Deputy Presiding Officer

That concludes the statement. There will be a short pause before we move on to the next item of business, to allow the front bench teams to change position, should they wish to do so.

National Health Service Dentistry

Annabelle Ewing (Scottish National Party, Cowdenbeath)

The next item of business is a debate on motion S6M-07812, in the name of Alex Cole-Hamilton, on addressing the crisis in NHS dentistry.

Alex Cole-Hamilton (Liberal Democrat, Edinburgh Western)

I am very pleased to rise for my party to speak in this debate. There is a dentistry crisis in Scotland. It can be felt everywhere—it is visited in each of our mailbags and is inflicting pain on people up and down the country every day—yet the Government’s amendment seeks to delete that reality from the parliamentary proceedings. That is astonishing. Again, it shows the cognitive dissonance that we have come to know well from the Government, which has its head in the sand and displays the dead hand of ministerial disinterest in things that matter to real people.

Indeed, it was a show of astonishing timing that the Government published a letter last night that evidenced its paltry effort in kicking issues down the road, with promises of jam tomorrow to our hard-working dentists.

Far too many Scots face huge obstacles in accessing NHS dental check-ups. The number of NHS treatments that are being conducted is dramatically below pre-pandemic levels. Liberal Democrat research has revealed soaring waits for dental treatment, with some patients waiting more than three years for help. Imagine having to deal with dental pain for three years—it is astonishing.

The situation is dire right across the country. Eleven health boards recorded patients having to wait more than a year for treatment. A freedom of information request to health boards showed that dentists submitted about 3.2 million claims for NHS work between January and November last year. That sounds like quite a lot, but if we compare that with the 5.6 million claims for NHS dental work in 2019, we start to understand the quantum of the problem and the fall-away in dental work.

Put simply, many people either are forced to wait months for NHS dental treatment or are unable to access NHS care at all. In rural communities, the situation is even more acute. In Orkney and Shetland, the number of NHS dental claims has fallen by more than 50 per cent, while many practices in Dumfries and Galloway have closed their doors to NHS work entirely. The warning lights are well and truly on, and they are blinking, but the Government’s response has been achingly slow.

Let us think about how we got here. The business model for dentistry is straightforward. There has always been a balance between NHS work and private work, but, over time, stagnation in payment for NHS work has led to that balance shifting inexorably towards private work. That is not the fault of dentists—they have people to employ, lights to keep on and bills to pay at home. It is a result of, as I said, ministerial disinterest in the funding model. We know from senior dentists that the Government has, in their words, had its head in the sand.

I note that the Government has, once again, referenced the impact of the pandemic. The pandemic has, of course, had an impact. We know that that is, in large part, why there has been a backlog of procedures. However, as Paul Gray, the former chief executive of NHS Scotland, said, the crisis in our NHS, including in dentistry, was always coming—Covid just hastened the date.

The Government talks in lofty tones about protecting our NHS from privatisation. It rightly speaks of prescription charges being a tax on the sick. However, under the Scottish National Party-Green Government, thousands of people are denied the dental treatment that they desperately need. Why are they denied it? It is because they simply cannot afford to pay for private treatment, which is the only other option available to them.

Of those who responded to a United Kingdom-wide poll that was conducted by my party last year, a quarter of people said that they were forced to pay for private dental treatment. Many people said that they delayed seeing a dentist despite suffering pain. When the pain got too bad, many of those who could not afford to go private turned to DIY dentistry. That means that they carried out dental work on themselves or asked somebody equally unqualified to do it for them.

Last year, a staggering one in five people who failed to get an NHS dental appointment resorted to that. Imagine that. We are not living in the dark ages; this is 21st century Scotland. The fact that so many people are being forced to take such a measure is a national scandal and an absolute indictment—

Sandesh Gulhane (Conservative, Glasgow)

Does Alex Cole-Hamilton agree that, since the Scottish Conservatives previously brought a debate on dentistry to the chamber, things have got worse?

Alex Cole-Hamilton (Liberal Democrat, Edinburgh Western)

Dr Gulhane is absolutely right: things are getting worse.

I am sad to say that I sometimes fear that we are becoming inured to the level of crisis in our dentistry profession. [

Interruption

.]

The Deputy Presiding Officer

Excuse me. Could we not have sedentary chitchat, please? Thank you.

Alex Cole-Hamilton (Liberal Democrat, Edinburgh Western)

If the cabinet secretary wants to come in, I would be quite happy to take an intervention.

Humza Yousaf (Scottish National Party, Glasgow Pollok)

Does Alex Cole-Hamilton recognise that Brexit, along with the pandemic, has had an impact on the dental workforce? If so, does he therefore disagree with his party’s leadership, which wants to keep us out of Europe?

Alex Cole-Hamilton (Liberal Democrat, Edinburgh Western)

Wow. I think that I have turned up to the wrong debate. [

Interruption

.] Nevertheless, I invite the cabinet secretary to explain that to senior dentists, who have told us that his Government has its head in the sand.

Obviously, Brexit has played its part. My party opposed Brexit and it is still opposed to it. Nevertheless, the cabinet secretary cannot once again shirk any responsibility by either blaming the pandemic or Brexit for his Government’s inadequacies and his own ministerial disinterest.

I wish it were just hyperbole, but when healthcare in this country is in such dire straits that people are literally being forced to pull out their own teeth, the use of the word “crisis” in the motion feels far too modest, and I cannot believe that the Government sought in its amendment to remove that word.

It should go without saying that tooth care, like any other form of healthcare, should be universally accessible and free at the point of delivery. Scottish Liberal Democrats were instrumental in introducing free dental checks in Scotland when the party was in coalition with Labour and in pressing for a new dental school to address shortages in the dentistry workforce. However, over the past 15 years, Scottish dentistry has been left to rot in the incapable hands of the Scottish National Party.

We find ourselves in this situation because our national health service has been starved of funding. The money that dentists are being given every time they carry out an NHS procedure is not going far enough to make the work sustainable, with some even running at a loss. Unsurprisingly, more and more dentists are becoming fully private, with only 18 per cent of practices taking on new NHS patients.

The Liberal Democrats have solutions. We want the Government to reform the existing funding structures for dentistry, so that dentists are incentivised to take on NHS patients. We want the Government to rewrite the NHS recovery plan so that it includes dentists in more comprehensive ways and properly recognises the importance of dentists in the course of that recovery. People are suffering. It is time that the Government woke up to that.

I move,

That the Parliament believes that there is a crisis in NHS dentistry; notes that the number of NHS dental check-ups and treatments being conducted are dramatically below pre-COVID-19 pandemic levels; further notes with concern that the number of dentists who are carrying out NHS work has fallen in 11 NHS boards, with the chair of the British Dental Association’s Scottish Dental Practice Committee warning of a “wholescale exodus” from the sector; understands that most dentists are not accepting new NHS patients and that polling has shown that many of those registered have been unable to get appointments; believes that the lack of government action to resolve this is leaving people in pain and will cause wider mouth health issues to be missed, and calls on the Scottish Government to rewrite the NHS Recovery Plan so that it includes dentistry fully and properly recognises the importance of dentists in the course of the recovery, and to urgently reform the funding structures so that dentists can return to taking on NHS activity and enable more patients to be seen.

The Deputy Presiding Officer

I call Maree Todd to speak to and move amendment S5M-07812.3. You have up to six minutes, please, minister.

Maree Todd (Scottish National Party, Caithness, Sutherland and Ross)

I am grateful for the opportunity to debate the important matter of access to NHS dental care, given the unprecedented impact of the pandemic and the uncertainty that that has caused. I am pleased with the progress that we are making, and I am glad that we were able to confirm that we are maintaining the current bridging payment until 31 October, incentivising NHS work.

I am sure that everyone in the chamber will recognise that NHS dental services have undergone a significant and prolonged period of recovery. Members will recall that patient access to NHS dental services was severely reduced during the pandemic, as sensible public health precautions were required to mitigate the possible transmission of Covid-19 in dental surgeries. We are seeing encouraging signs of improving patient access to care.

The Scottish Government supported dental practices through the pandemic, including through the provision of an additional £150 million to maintain the sector. That includes vital financial support payments being made to contractors to secure continued NHS dental service provision.

NHS dental services are on the road to recovery. I am sure that members will wish to share my admiration for NHS dental services as sector recovery continues. That is highlighted by the completion of more than 1.6 million NHS examination appointments between April and October 2022.

In 2022-23, an average of 300,000 courses of treatment a month have taken place, highlighting an improvement on the 2021 figures.

Far from the picture that Alex Cole-Hamilton has painted, that means that we are on course for an increase of 40 per cent in NHS dental activity compared with 2021-22. It also means that we have made considerable progress towards pre-pandemic levels.

Additional support payments have been provided in each quarter of the current financial year, on top of item of service claims, to support contractor incomes and, crucially, to enable patient care to be delivered.

Alex Cole-Hamilton (Liberal Democrat, Edinburgh Western)

Will the minister give way?

Maree Todd (Scottish National Party, Caithness, Sutherland and Ross)

Certainly—if the member is brief.

Alex Cole-Hamilton (Liberal Democrat, Edinburgh Western)

The minister talks about the uplift in dental work compared with 2021-22. I remind her that non-aerosol generating procedures were not allowed in 2021-22, so an uplift of 40 per cent is hardly something to be congratulated on.

Humza Yousaf (Scottish National Party, Glasgow Pollok)

It is progress!

Maree Todd (Scottish National Party, Caithness, Sutherland and Ross)

There you go. It is undeniable that we are making progress—really good progress—towards pre-pandemic levels.

We are still in the midst of a global pandemic.

Jackie Baillie (Labour, Dumbarton)

Will the member give way?

Maree Todd (Scottish National Party, Caithness, Sutherland and Ross)

Give me one moment to make some progress.

There is now a clear necessity to provide continued support to the sector as we move to the payment system reform. The improving picture on patient access to care underpins the need for longer-term, sustainable payment system reform to provide surety of NHS provision. The development of the NHS dental payment reform has been built in the spirit of clear engagement with the sector; indeed, I am really pleased to report to members that the chief dental officer’s advisory group, which contains practising NHS dentists and members of the dental team, has been prominent in developing the clinical requirements of those reforms, building on our oral health improvement plan approach.

In discussion and engagement with the British Dental Association Scotland, there has been further development of the payment system reform programme, which is informing us on the correct course to take to seek agreement on the overall package of reform.

Members will welcome the open approach to the development of reform with a focus on preventative care. The payment system reform supports enhanced clinical discretion and will support clinicians to deliver effective, high-quality care to patients.

Jackie Baillie (Labour, Dumbarton)

I welcome the minister’s contribution, which is outlining reform, but can she please give us a timetable?

Maree Todd (Scottish National Party, Caithness, Sutherland and Ross)

The timetable is clearly seen in the commitment to maintaining the bridging payments to the end of October this year; we expect the new system of reform payments to be in place by then.

The Scottish Government has ensured that NHS dental services are well placed to recover from the impacts of the pandemic to deliver care for the oral health of the whole population. We are committed to tackling the pandemic-related backlog in routine dental care and have supported the sector continuously.

The improved position reflects well on the commitment of NHS dental contractors and their wider clinical teams.

Finlay Carson (Conservative, Galloway and West Dumfries)

The minister has mentioned improvements. Could she point to the improvements in Dumfries and Galloway? Dentists are not leaving the region but leaving the NHS—we are seeing a huge increase in private dental care.

Maree Todd (Scottish National Party, Caithness, Sutherland and Ross)

The member is well aware of the particular conditions in Dumfries and Galloway, which have contributed to the situation in which we are now. That area is particularly impacted by Brexit. More than 60 per cent—[

Interruption

.]

The member should go ahead if he wants to make another intervention.

The Deputy Presiding Officer

Briefly, Mr Carson, because the minister should now be bringing her remarks to a close.

Finlay Carson (Conservative, Galloway and West Dumfries)

I appreciate the minister taking the intervention.

The Brexit remark was going to come; we were just waiting for it—it is like bingo. Dentists are not leaving dentistry; they are leaving the NHS to go private.

Maree Todd (Scottish National Party, Caithness, Sutherland and Ross)

I know that the member does not like us to talk about Brexit. However, more than 60 per cent of the dental workforce is European, so it is undeniable that Brexit is a factor in the situation that has arisen in the member’s region. What we are seeing here is the member’s head in the sand about a situation that his party has brought about in his local area.

The early intervention to support enhanced examinations in February 2022, which includes the provision of a fee for child examinations, is reflected in the official statistics, which show considerable progress in the delivery of patient care and treatment as we come out of the pandemic. I am clear that our support of the sector has ensured its recovery.

As well as the impact of Brexit on the workforce, a whole year of dental students have not qualified. However, despite those challenges, we have seen a 23 per cent increase in dentists providing NHS dental services from 2007 to 2022—the period that the SNP has been in power.

The Deputy Presiding Officer

You are over your time; you need to conclude, minister.

Maree Todd (Scottish National Party, Caithness, Sutherland and Ross)

More than 95 per cent of the Scottish population continues to be registered with an NHS dentist—a situation that we are determined to progress and improve.

I move amendment S6M-07812.3, to leave out from the first “believes” to end and insert:

“recognises the impact that the COVID-19 pandemic had on the provision of dental services; thanks all NHS dentists, dental nurses and wider staff for their efforts to provide dental care for the people of Scotland; supports the reform of the NHS dentistry payment system to ensure that the recovery that has been seen in the last year can be built upon; understands that the bridging and multiplier arrangements supported significant increases in activity; notes that, since the start of the pandemic, dentistry has been provided with over £150 million of additional support to sustain the sector; further notes that 95.4% of people in Scotland are registered with a dentist, an increase of 44.3% since 2007; commends the work of the Childsmile programme, which is delivering preventative efforts to improve dental health now and in the future; welcomes the abolition of NHS dental charges for everyone under the age of 26, and supports the removal of all such charges by the end of the current parliamentary session.”

The Deputy Presiding Officer

Thank you, minister.

I call Sandesh Gulhane to speak to and move amendment S6M-07812.2.

Sandesh Gulhane (Conservative, Glasgow)

NHS dentistry is in crisis. That is happening on the SNP’s watch, yet when we listen to the minister, the message seems to be, “Aren’t we doing well?” That does not wash. This is really not the time for tiresome, self-congratulatory spin.

Maree Todd (Scottish National Party, Caithness, Sutherland and Ross)

I am very clear in acknowledging the challenges that the sector faces at the moment. Would Sandesh Gulhane join me in recognising the very welcome statistic that there has been a 23 per cent increase in the workforce in NHS dentistry during the SNP Government’s time in office?

Sandesh Gulhane (Conservative, Glasgow)

The minister will hear in the rest of my speech how badly the Government has been doing when it comes to NHS dentistry, so I ask her to listen. [

Interruption

.]

The Deputy Presiding Officer

Excuse me. Please resume your seat for a second, Dr Gulhane.

Obviously, this is a very important issue, but we really need to listen to everybody and extend to others the courtesy and respect that we would all hope to have extended to us as individuals.

Sandesh Gulhane (Conservative, Glasgow)

No matter how many Scots are registered with a dentist or what age groups are entitled to free NHS dental care, members miss the point if patients cannot access NHS dental services or if dental practices are going to the wall. The SNP-Green Government must get a grip and bring forward a credible plan to both restore routine dental care and tackle the enormous backlog—and that plan should not include moving the goalposts.

What do I mean by that? We understand that the latest draft of a revised statement of dental remuneration proposes to create capacity by changing the frequency of NHS oral check-ups from once every six months to once every 12, 18 or even 24 months. In other words, that means a cut to patient care and further privatisation by the back door, as patients who want to be checked out sooner will need to pay. So much for preventative healthcare—and the proposal should be considered against a backdrop of particularly worrying reports from dentists of children’s poor oral hygiene and health, especially in areas with higher levels of deprivation, and a growing requirement for early tooth extractions.

The Scottish Government must act on the dire warnings from the British Dental Association that the system is broken. This is about not simply hearing but heeding the words of professionals. If a new sustainable NHS dentistry model is not in place by October 2023, the decision to extend the 1.1 multiplier—which, we must remember, has fallen sharply—as a bridging payment will lead to inevitable collapse.

The traditional high-volume, low-margin model is unsustainable. Without reform, practices will be pushed into bankruptcy or forced to drop NHS services altogether. Practices point out that they already face the risk of providing NHS care at a loss in relation to laboratory work.

I will give an example. Practices receive £153.34 for a full set of upper or lower dentures. That includes the 1.1. multiplier. The average lab bill is £90, so the margin is £63.34, which is split 50:50 between the practising dentist and the practice owner—who, in turn, must pay at least two members of staff over five or six appointments. As another example, a single extraction is £20.30 gross. Many dentists book a 30-minute appointment for such treatments, and rushing them helps neither the staff nor the patient.

The system is now geared towards saving the Scottish Government money, and not towards patients’ dental health. Can the Scottish Government reasonably argue that practice owners can afford to support any of those treatments, or that experienced associate dentists will continue to accept NHS dentistry work? Motivation is genuinely at an all-time low.

Material and lab fees have risen by 20 to 40 per cent across all practices.

Humza Yousaf (Scottish National Party, Glasgow Pollok)

Will the member give way?

The Deputy Presiding Officer

The member is in his final minute.

Sandesh Gulhane (Conservative, Glasgow)

That can be supported only through a greater emphasis on private treatments and by putting many deserving, but non-urgent, NHS patients on an indefinite waiting list until something gives.

There is also a lack of dental nurses and dentists, which means that many practices are unsustainable and will fold. Recent data indicates that claims submitted by NHS dentists for dental work are 43 per cent down on 2019 levels and suggests a growing exodus from the NHS workforce.

Across his health and social care brief, the cabinet secretary is responsible for multiple failures. It is time for the Government to work with dentists to prevent a collapse of NHS dentistry and to provide the sector with adequate financial support so that it can continue to offer NHS dentistry. I make this plea: heed the words of the professionals and deliver the care.

I declare my interest as a practising NHS general practitioner.

I move amendment S6M-07812.2, to insert at end:

“; believes that a root and branch reform of dental tariffs is required to ensure that dentists can holistically manage oral health; recognises what it sees as increasingly worrying reports from dentists of poor child oral hygiene, especially in areas with higher deprivation, and a growing requirement for early tooth extractions, and believes that the Scottish Government’s lack of a dentistry recovery plan will only exacerbate this growing health inequality.”

Paul Sweeney (Labour, Glasgow)

Labour agrees with the Liberal Democrat motion and will support it if it is unamended. Our amendment seeks to add a request that the Government

provides an update on the progress that has been made with its oral health improvement plan, which I hope is something that every member can agree with.

I thank the member for Edinburgh Western for bringing his motion to the chamber for debate. NHS dentistry and dental services are often overlooked and tend not to generate the headlines that we see in relation to acute NHS services or, indeed, mental health services, but that does not mean that they are any less important. After all, in the same way that we will all need some form of medical treatment during our lives, we will all need dental treatment, too. Therefore, it is vitally important that people can rely on dental services and are confident that they will be able to receive treatment in a speedy manner when the time comes.

That takes us to the very heart of the issue. At present, there is a postcode lottery when it comes to the availability of dental services in Scotland. In August last year, the British Dental Association and the BBC identified more than 8,500 dental practices across the UK that they believed held NHS contracts. As part of their research, they contacted almost 7,000 practices to find out whether they were able to offer appointments to new adult or child NHS patients. In Scotland, a staggering 82 per cent were not accepting new patients. Even more shockingly, the researchers were unable to find a single practice in Dundee, Midlothian, Dumfries and Galloway, Moray, Orkney, South Ayrshire or the Western Isles that was taking on new adult or child NHS patients.

We face a crisis that is creating a two-tier dental system in Scotland. Patients who are unable to afford private dental care are forgoing services entirely in a crisis that risks collapsing NHS dentistry in Scotland in the long term to a basic extraction service—getting a tooth yanked out, if you needed to, because you were in pain.

We are already seeing the beginning of that demise. In 2022, more than 2 million fewer patients were seen by NHS dentists, compared with 2019. When it comes to participation rates, the situation is even worse and tells a tale of widening oral health inequalities among children and adults. In September 2008, the gap in child participation rates between the most and least deprived quintiles in Scottish society was 3 percentage points. In September last year, it was 20 percentage points, which is the highest difference that has ever been reported. That is shocking. Over the same period—from September 2008 to September last year—the gap in adult participation rates between the most and least deprived quintiles grew from 3 percentage points to 11 percentage points, which, again, is the highest difference that has ever been reported.

Why does that all matter? It matters because those cold, hard facts are illustrative of a bigger problem—an inertia in the Scottish Government when it comes to our healthcare system and, in particular, inequality in our healthcare system. We know what problems our NHS faces. One of those problems is that of staff retention, which exists in dental services, too.

Just last week, the BDA issued a stark warning:

“In just two months the ‘bridging payments’ to NHS practices in Scotland will cease. There is no clarity on what support will take its place.”

That is a terrifying prospect.

Humza Yousaf (Scottish National Party, Glasgow Pollok)

As Paul Sweeney may well know—Alex Cole-Hamilton might have mentioned this—we have agreed to extend the provision of bridging payments till October. I am sure that he will welcome that.

Paul Sweeney (Labour, Glasgow)

I accept that that is the case, but, as my dentist told me yesterday, that will not offset the multiplier effects that were previously in place, and it does not address the financial detriment that is faced by dentists. There is no reason for them to engage. The extension of bridging payments is not sufficient to address the problem.

The situation is compounded by the fact that many dentists—young dentists, in particular—are simply leaving the profession. The BDA went on to warn that

“An exodus from the workforce appears to be in motion”,

and that

“Dentists are reconsidering their futures working in a broken system”,

as is happening with junior doctors.

That should be of huge concern. Without a highly skilled and trained workforce that is able to provide NHS dental services to adult and child patients, a fundamental cornerstone of our public dental system will collapse and, when it does, it will be those from the most deprived backgrounds who will suffer. My plea to the minister and the cabinet secretary is simple: listen to the sincere warnings from professionals in the field, harness their expertise and bring to the Parliament a plan that can command support from across the chamber before it is too late.

I move amendment S6M-07812.1, to insert after “Scottish Government to”:

“provide an update to the Parliament on the progress made in delivering on its Oral Health Improvement Plan, which was published over five years ago,”.

The Deputy Presiding Officer

We move to the open debate.

Willie Rennie (Liberal Democrat, North East Fife)

The Liberal Democrats seem to have spooked the health secretary. On the eve of this debate, he rushed out a letter to NHS dentists across the country. In it, he promised an extension to the interim bridging payments to October, when they were supposed to have been sorted in April, as he referred to. He also said in the letter that he was “pleased” and “grateful”, but I do not think that many dentists will be pleased with and grateful for the Government’s performance.

Under the current funding system, dentists are losing money with every procedure that they undertake. Sandesh Gulhane gave some excellent examples. Lab costs for dentures are estimated to have gone up by 50 per cent. One dentist told me:

“I have made dentures recently and lost £6.00 on”

every single

“job.”

As in so many other sectors, the SNP Government is expecting private work to subsidise public work.

That

is happening with nurseries and in higher education, too.

Gillian Martin (Scottish National Party, Aberdeenshire East)

My dentist told me that one of the biggest increases in costs is for dental equipment and supplies that come from the European Union. That has made a big difference to their margins.

Willie Rennie (Liberal Democrat, North East Fife)

The member is absolutely right, and that reinforces the case for the Government to reflect on the real costs that dentists are facing, or else we will drive more of them into the private sector, which will have a direct impact on those who are seeking NHS treatment.

It is pretty clear that it is increasingly difficult to see an NHS dentist. The numbers are transparent. Although there has been an increase since the record lows of the pandemic period, it has been modest. We have heard that, since 2019, there has been a 20 per cent fall in the number of dentists performing NHS procedures, and around a quarter of people seeking a dentist appointment have not been able to get one. That is really stark.

The situation forces more people into private treatment. Those people are expected to pay not only for their own treatment, but for the SNP’s underfunding of NHS treatment. I do not think that it is particularly fair that people who are desperate to get NHS treatment have to go private and are also having to subsidise NHS treatment. The SNP is killing NHS dentistry by stealth.

Patients in my constituency are hunting from practice to practice to access treatment. I have to say that it is, therefore, an utter farce that the SNP continues to promise that it is going to abolish all NHS dental charges. That goal is worthy and not unreasonable, but it misses the point of the crisis in NHS dentistry.

Someone

might be able to get free treatment if they are being treated under the NHS, but only if they can get an NHS dentist. Treatment will not be free for everyone; it will be free only for those who can get through the door of an NHS dentist. Yet the SNP gets its headline.

Bob Doris (Scottish National Party, Glasgow Maryhill and Springburn)

Will the member take an intervention?

The Deputy Presiding Officer

The member is just concluding.

Willie Rennie (Liberal Democrat, North East Fife)

This comes at a time when, following the pandemic, the people who need dentistry most are the slowest to come forward. As

Paul Sweeney rightly identified, that is exacerbating inequalities, particularly among children. We are posing a significant risk to the population, who may be at risk of diabetes, HIV and cancer.

It is no surprise that there has been an increase in the number of people resorting to treating themselves. The cabinet secretary needs to accept that there is a crisis in NHS dentistry. If he does not do something about it soon, it will get a whole lot worse.

Siobhian Brown (Scottish National Party, Ayr)

I am glad that the Liberal Democrats are using this parliamentary debate to address NHS dentistry in Scotland.

After reading the 2021 Scottish Liberal Democrat manifesto to learn a bit more about their party’s plans and ambitions for dentistry in Scotland, I am afraid to say that the Lib Dems did not mention dentistry once in that. On the other hand, back in 2021, when Covid was still very real, the SNP dedicated a whole section in our manifesto to how we can improve dentistry services, and action has already been taken.

It goes without saying that significant challenges face dentistry and our health service in Scotland, but we need to recognise the impact of the global pandemic, which has been the biggest shock to our NHS in its 74-year history. The NHS is not going to recover in a few weeks, as all the Opposition parties demand; recovery will take years.

Jackie Baillie (Labour, Dumbarton)

Will the member take an intervention?

Siobhian Brown (Scottish National Party, Ayr)

Will I get the time back, Presiding Officer?

The Deputy Presiding Officer

There is no time in hand.

Siobhian Brown (Scottish National Party, Ayr)

Apologies to the member. I will not take the intervention.

Let us dive into some facts. Right now, more than 95 per cent of people in Scotland are registered with an NHS dentist. I was shocked to learn that, back in 2007, only 44.3 per cent of people were registered with a dentist. The progress is down to the work of this SNP Government and represents a massive uptake, following years of decline under Labour and Lib Dem Governments.

Examinations and appointments are again up, following the massive backlog that was the result of the global pandemic. To date, the SNP Government has provided more than £150 million of financial support to maintain the capacity and capability of NHS dentistry. I am not sure whether Alex Cole-Hamilton is aware that, in a proactive move after the pandemic, the payment system of fee per item that incentivises NHS dental teams to see patients was reintroduced last April. Public Health Scotland statistics show how the measure has increased patient examination appointments, so that they are back to pre-pandemic levels, allowing more patients to be seen and dental practices to register more patients as they work though the pandemic backlog.

Since the SNP came into office, considerable progress has been made in dental services and oral health improvement. The Scottish Government has removed dental charges for all patients under 26—that is around 600,000 young Scots—as a first step towards scrapping charges for all in Scotland.

Partly because of that policy, our children’s oral health, particularly in deprived communities, is improving dramatically, with the primary 7 group showing better results than ever. The childsmile programme was introduced in nurseries and schools. I witnessed the programme in practice last week on a visit in Troon. Great work is being done.

We have more dentists per head of population. In Scotland, we have 59 dentists per 100,000 in comparison to 43 per 100,000 down south. Do we want more dentists? Yes. However, due to the pandemic, we had a whole year when no dental students qualified.

Immigration could play a key role in tackling the backlog. I await the groans from the Tory benches when I say that the hard, cold fact—and this is not Brexit bingo; this is not a game—is that Brexit has had a significant, detrimental impact on recruitment of health and social care staff.

Finlay Carson (Conservative, Galloway and West Dumfries)

Will the member give way?

The Deputy Presiding Officer

The member is in her final minute.

Siobhian Brown (Scottish National Party, Ayr)

One hard, cold fact is that the rate of dentists joining the register has halved since the EU referendum. The Nuffield Trust report, “Health and Brexit: six years on”, which was published in December, describes the UK’s dentist workforce as a particular concern. It says:

“Before the EU referendum, consistently well over 500 dentists trained in the EU and EFTA registered in the UK each year. They made up around a quarter of additions to the workforce. This dropped sharply around the time of the referendum, to around half its previous level, and has never recovered.”

I am sorry. I have run out of time, Presiding Officer. I will conclude there.

Brian Whittle (Conservative, South Scotland)

I thank the Liberal Democrats for using their debating time to bring this hugely important issue to the Parliament.

Members will be aware of my long-standing interest in the preventative health agenda. Dentistry sits firmly in the category of preventative healthcare. Furthermore, when we discuss health inequalities, we cannot avoid the fact that the most deprived areas are suffering far more than the least deprived areas.

I had hoped that, given her experience, the minister would be prepared to accept that there is a long-standing issue to do with access to dental care and that there is a disparity between the most and least deprived areas when it comes to oral hygiene. I had hoped to discuss the issue without politics getting in the way, because it is far too important an issue for members to play politics.

However, reality bears no resemblance to the Government’s amendment.

Maree Todd (Scottish National Party, Caithness, Sutherland and Ross)

Will the member take an intervention?

Brian Whittle (Conservative, South Scotland)

I want to make some progress first.

Covid makes its usual appearance in the Government’s list of excuses when we discuss anything that is health related. For the record, I looked at trends in the percentage of registered patients who participated in NHS general dentistry services in Scotland from 2006 until now. The minister should be aware that it has consistently fallen, from a high of 96.7 per cent in 2006 to 65.7 per cent now. All that Covid did was accelerate an already chronic problem.

Furthermore, the number of dentists working in the NHS has been steadily declining over the past six years, with the biggest decline in the past two years. We can extrapolate those results to conclude that an already declining state of oral health and hygiene in Scotland has been accelerated, and it is reasonable to conclude that the most deprived will suffer the worst consequences.

I have convened the cross-party group on health inequalities for nearly seven years, and our frustration is that the issues that we discussed way back then are the same issues that we discuss now, only they are much worse. Our amendment, which I hope will get the support of members from across the chamber, is born out of

“increasingly worrying reports from dentists of poor child oral hygiene, especially in areas with higher deprivation, and a growing requirement for early tooth extractions, and believes that the Scottish Government’s lack of a dentistry recovery plan will only exacerbate this growing health inequality.”

Those words may be in our amendment, but they are also a direct quote from a senior dentist.

Good oral hygiene is the epitome of the preventative health agenda. By investing in early intervention—

Maree Todd (Scottish National Party, Caithness, Sutherland and Ross)

I am absolutely sure that the member will welcome the enhanced child examination fee that has been in place since 2022. Does he also welcome the fact that, in 2003, 45 per cent—less than half—of primary 1 children had no obvious decay but that, by 2021-22, that number had increased to 73 per cent? That does not fit with the narrative that the member is presenting about the SNP’s management of preventative health in children.

Brian Whittle (Conservative, South Scotland)

What the minister just said does not fit with the narrative that we hear from dentists day in and day out. It is about time that the SNP Government started listening to the people who work on the front line, because the words in our amendment that I mentioned are a direct quote from a senior dentist.

By investing in early intervention, the Scottish Government would avoid much more costly and invasive treatments further down the line. The issue is not just cost; it is also about investment and being able to continually reinvest in the dentistry profession to the betterment of the profession and its patients, and tackling that growing health inequality.

It is no good for the Scottish Government to create ambitious targets with no route to related outcomes of their policies. I had hoped that we would have an honest and open debate on this very serious and escalating health crisis, but, unfortunately, we are not getting that from the Scottish Government. An “everything will be fine” and “nothing to see here” policy will not wash, and it is time that the Scottish Government accepted the severity of the situation, that its policies to date have not worked and that we need a complete root-and-branch review of dentistry.

Paul O'Kane (Labour, West Scotland)

Our NHS dentistry services are experiencing unprecedented levels of pressure and, not for the first time in the health sector, the Scottish Government has taken its eye off the ball. Its mismanagement of NHS dentistry has left the sector fighting for its survival.

Since the onset of the pandemic, more than 6 million NHS dental appointments in Scotland have been lost. That includes essential annual check-ups, which are a cornerstone for maintaining good oral health, as any potential issues can be identified early and properly assessed, which boosts the likelihood of a positive outcome.

Since coming to power, not only has the SNP-Green Government presided over the privatisation of dentistry services in Scotland, it has accelerated the process of privatisation. In response to any criticism or scrutiny, as we have again seen today during the debate, the Scottish Government gives its excuses, one of which is to state that 95 per cent of Scots are registered with a dentist. However, being registered with a dentist is meaningless if you cannot access an appointment for several weeks or if you cannot afford the expense of going private, particularly in our most deprived communities where access to such appointments is crucial.

The impact of the widespread privatisation of dentistry services is a marked increase in health inequalities, most prominently among children. New research from the British Dental Association has found that the proportion of people who have visited their dentist in the past two years has fallen from 65 per cent in 2020 to only 50 per cent in 2022. Three in every four children have visited their dentist in the past two years compared with just more than one in two children in the most deprived communities.

When the SNP came to power, as we have already heard from my colleague Paul Sweeney, the difference in dental participation rates between children from the most affluent areas and those from the most deprived communities was only 3 per cent; it is now 20 per cent. That is a shameful statistic, which is indicative of the SNP’s shambolic management of NHS dentistry and its lack of targeted action over 15 years to reduce health inequalities.

We are faced with the reality of dental care being a privilege that can be accessed only by those who have enough disposable income to seek private treatment.

I would like to say that I was pleased to hear the minister confirm that the Scottish Government has extended the bridging payments, which update the NHS fees to help dental practices to deal with rising costs—that is what the minister said would happen—but I do not think that we have had any acknowledgement of the multiplier effects or the systemic issues with the current funding model, which is completely broken and is accelerating the shift away from NHS dentistry and into private practice.

Sandesh Gulhane (Conservative, Glasgow)

Will the member take an intervention?

Paul O'Kane (Labour, West Scotland)

I am in my last minute, but I will take a very brief intervention.

Sandesh Gulhane (Conservative, Glasgow)

Does Paul O’Kane think that dentists would agree that holistic oral health is a priority and that we should not continue with the drill-and-fill model that the Scottish Government is pursuing?

Paul O'Kane (Labour, West Scotland)

In my speech, I think that I have outlined the importance of the relationship with the dentist in ensuring that a person’s appointment is their gateway to the services that they require for good oral health.

“What’s needed now is real reform to a broken system. There can be no more kicking the can down the road—a sustainable model must be in place come October.”

Those are not my words; they are the words of the chair of the British Dental Association’s Scottish dental practice committee, David McColl.

As a matter of urgency, the Scottish Government must fix the systemic issues in the current funding model if it is serious about maintaining a universal NHS dentistry service across Scotland. We need to shift the debate away from the proportion of the public who are registered with a dentist and focus on who is able to access a dental appointment.

If action is not taken, we will see the end of dentistry as we know it in Scotland, with a two-tier system of care: one for the rich and one for the rest.

Alison Johnstone (Presiding Officer, Lothian)

I have to ask you to conclude now, Mr O’Kane.

Paul O'Kane (Labour, West Scotland)

That will only exacerbate and further entrench existing health inequalities in oral health.

Gillian Mackay (Green, Central Scotland)

I, too, am pleased that we have time today to discuss dentistry. Dentistry is a part of the health service that often gets lost when we are discussing wider health issues. It is a hugely effective preventative health measure that involves not only teeth and gum health, but finds other potential issues and conditions.

As it has done on all parts of our health service, Covid has placed unprecedented pressure on dentistry, so I commend all the dentists, therapists, hygienists, nurses and technicians who put their wellbeing, and sometimes their lives, at risk to continue delivering essential healthcare during the pandemic.

It is only right, though, that we look at the issue in the context of how dentistry is delivered in Scotland, which is fundamentally different to general practice and other healthcare services. As such, our response to Covid recovery for dentistry needs to be different to our response for other parts of healthcare.

The mixed model of private dentistry, general practice and the public dental service creates a complex system that the public are not always confident in negotiating. It also opens real risks of there being uneven and inequitable delivery of dental services across the country.

We should also consider expanding the role of the public dental service, with healthcare boards fully delivering dental services. Historically, that has been reserved for communities that are unable to access dentists—for example, people who live in care homes—but in recent years, the NHS has successfully delivered full dental services in remote and rural areas including the Western Isles, which had been badly served by general practice. The public dental service provides an existing model that could be expanded to cover more communities—especially communities in which private and general practices are closing, or where growing populations are not adequately served by existing practices.

Although the model of delivery might be different, there are clearly lessons that can be learned from the way in which GPs have adapted to delivery of primary healthcare—not least through successful use of allied health professionals as part of wider health teams in surgeries. The wider categories of dental care professionals include dental therapists, hygienists, technicians and extended duty dental nurses, who can provide a wide range of services, from extractions to preventative care. They are already used extensively across Scotland, but currently have to work on a refer-down model, in which patients must see a dentist before being referred for further treatment to a dental care professional. That is the opposite to how GP practices work, where it is now common to see a nurse before being referred for further treatment elsewhere, and it is not how dental care professionals work in other parts of the UK.

Reviewing the model and changing to a refer-up system could significantly ease current pressures on dental services and ensure that we are making full use of our well-trained and highly skilled dental care professionals.

I welcome the removal of dental care charges for under-26s and I hope that we can, before extending it to the rest of the population, look at how to roll that out quickly to groups for whom paying for dental care is a barrier. Some groups are already exempt from charges—for example, people who are pregnant and people who are in receipt of various benefits. However, I do not think that those exemptions are—especially in the current economic climate—capturing all the people for whom dental treatment might be a luxury that they cannot afford. I hope that we will be able to devise a targeted approach that addresses both availability of dentists in some areas and affordability.

We also need to look closely at why some people are not attending dental appointments and at how we can remove some of the barriers. Some people to whom I have spoken simply got out of the habit of going during the pandemic and have not got round to booking a check-up. We need to address that issue.

Dentistry is one of the greatest examples that we have of preventative care, so we need to ensure that everyone who might need dental care has access to it. We need to look at where and how it is delivered and make sure that it is not too long until the abolition of dental care charges.

Gillian Martin (Scottish National Party, Aberdeenshire East)

I have been concerned about the recruitment of dentists for some time. In 2018, local Inverurie NHS dentist Navin Aziz came to see me, claiming that, because of the Brexit vote, the profession was already seeing a 90 per cent drop in applicants for dentist vacancies. That was in the period before the actual withdrawal from the EU. Of course, now EU dentists need a work visa to come here—a visa that is difficult to get—and Mr Aziz was right; applications from the EU have all but ceased.

Mr Aziz also runs a couple of practices in the Highlands and was looking to recruit dentists from outwith the EU under the sponsor licence scheme, but there is a requirement for the dentist to earn £50,000, which was not within the pay scale that he could afford.

Brian Whittle (Conservative, South Scotland)

Will the member take an intervention?

Gillian Martin (Scottish National Party, Aberdeenshire East)

I do not have time.

Therefore, dentists could not apply through the other visa routes.

At that point, Amber Rudd was the Home Secretary, so I wrote to Ms Rudd and called on her to put in place contingency visa arrangements to take into account the impact of Brexit on dentists. I referenced another pressure that was highlighted at the time in a survey by the British Dental Association, which found that more than 50 per cent of NHS dentists across the UK were considering leaving the profession within the next five years and that a third of members over the age of 55 were looking to take early retirement. Unfortunately, I did not hear back, but that might have been because there were umpteen Cabinet reshuffles at that point.

Since then, Mr Aziz is in the fortunate position of having an SNP member of Parliament to take up his case with the current Home Secretary, but sadly he is coming up against the same brick wall. Mr Aziz continues to be unable to fill vacancies for which he has willing applicants. Incidentally, he is my parents’ dentist and they never have a problem getting an appointment, despite his recruitment challenges.

My colleague Jackie Dunbar will not speak in today’s debate, but she was telling me earlier of a similar case that she has. She is happy for me to relay the case because it mirrors Mr Aziz’s issue. She has a constituent who runs a dental practice in Aberdeen. He wanted to give a job to a dentist from Afghanistan to fill a vacancy, so he wrote to the Home Secretary to ask whether dentists are on the occupation shortage list in the UK and whether a specific scheme is in place to resettle dental graduates from Afghanistan, given the issues over there—

Jackie Dunbar (Scottish National Party, Aberdeen Donside)

Will the member take an intervention?

Gillian Martin (Scottish National Party, Aberdeenshire East)

Well, I will have to, won’t I?

Jackie Dunbar (Scottish National Party, Aberdeen Donside)

I thank Gillian Martin for taking the intervention and I apologise for hijacking her speech.

However, since my NHS dentist was mentioned, I want to give them a shout-out and thank them very much, and to thank all the NHS dentistry team. I broke a tooth last Thursday, so I called my dentist. It was not an emergency because it was not sore, so I was given an appointment for next Wednesday. I got a call this afternoon to say that there had been a cancellation and was asked whether I wanted to come in this afternoon. Obviously, I could not. I just wanted to thank that dentist and say that people can get appointments from the dentistry team.