Scottish Parliament, 8 May 2024

348 contributions from 69 members. The official report.

Portfolio Question Time

Liam McArthur (Liberal Democrat, Orkney Islands)

Good afternoon. The first item of business this afternoon is portfolio questions, and the first portfolio is rural affairs, land reform and islands. I invite members who wish to ask a question to press their request-to-speak button during the relevant question.

I advise members that we are extremely tight for time across the whole of the afternoon. There is quite a bit of interest in all three of the portfolios on which there will be questions. Therefore, the usual plea for brevity in questions and answers has added emphasis this afternoon.

Foysol Choudhury (Labour, Lothian)

To ask the Scottish Government how it plans to incorporate the ownership and management of community assets in urban areas into its Land Reform (Scotland) Bill. (S6O-03388)

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

The Land Reform (Scotland) Bill sets out ambitious proposals that will change for the better how land is owned and managed in our rural and island communities. I appreciate that one size and, indeed, one bill most definitely does not fit all. The Government recognises the need to continue to develop policies and programmes for land in urban areas that reflect local needs and priorities. That is why, in March, the Cabinet Secretary for Rural Affairs, Land Reform and Islands announced a review of the community rights to buy to look at how effective our current powers are in urban and rural areas.

Foysol Choudhury (Labour, Lothian)

In 2020, after the Heart of Newhaven primary school was closed, a community asset transfer brought the building into public ownership, allowing it to serve its area as a community hub. Local engagement is so important, yet the provisions on community engagement in the Land Reform (Scotland) Bill apply only to holdings that are thousands of hectares. Can the minister advise how the Scottish Government will ensure good use of areas of land that are smaller than those that are mentioned in the bill?

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

I absolutely take on board the point that Foysol Choudhury raises. The regeneration investment programme is supporting communities to develop and take ownership of land and assets across Scotland. To date, over £265 million has been invested through the regeneration capital grant fund, supporting nearly 230 community-led projects, and almost £27 million has been invested through the vacant and derelict land investment programme. That programme has brought back into use just over 112 hectares of persistent vacant and derelict land.

We will continue to deliver the vacant and derelict land fund. Five eligible councils are currently receiving a share of £7.65 million in 2023-24, and a figure of £5 million is planned for 2024-25.

Rachael Hamilton (Conservative, Ettrick, Roxburgh and Berwickshire)

Although we want communities to benefit from land ownership, it must be done in a way that is fair and proportionate. How will the Scottish Government determine when the lotting of land is in the public interest? What steps will the minister take to ensure that the Land Reform (Scotland) Bill complies with existing property rights?

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

The cabinet secretary is taking through the Land Reform (Scotland) Bill, and I am answering on her behalf, so I apologise if I do not give a full answer.

My understanding at this stage is that the Government was looking at a figure of over 1,000 hectares—it might be 3,000. I cannot honestly give the right numbers for that, but I know that the cabinet secretary has been looking at the issue, so we can get a fuller answer to the member in writing.

Alexander Burnett (Conservative, Aberdeenshire West)

To ask the Scottish Government when the rural affairs secretary last met with Forestry and Land Scotland. (S6O-03389)

I note my entry in the register of members’ interests regarding forestry and renewable energy.

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

As Alexander Burnett will be aware, the Cabinet Secretary for Rural Affairs, Land Reform and Islands regularly consults officials from Forestry and Land Scotland. I know that the member is aware that the cabinet secretary raised issues around flooding with Forestry and Land Scotland on his behalf. She regularly meets the organisation. The two most recent meetings, which were focused on finance, took place on 28 March and 1 May this year.

Alexander Burnett (Conservative, Aberdeenshire West)

New freedom of information figures show that, last year, more than a million trees on public land were felled to make way for wind farms. Constituents, such as those near Brown Hill forest at Craig Dorney, are reporting that forest roads that are owned by the Scottish Government are being improved to a higher specification than is required for simple timber extraction. That is clearly being done in expectation of wind farm developments that have yet to be consented, which makes a mockery of the approval process. Is the minister aware of such activity? Does he approve of it? Will those additional costs be met by wind farm developers, or are they just another cost being borne by the taxpayer?

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

I reiterate the point that I made to your colleague Rachael Hamilton: this is not my bill or my area. I was not aware of the issue that you have raised, but I will get the cabinet secretary to write to you with the details.

Liam McArthur (Liberal Democrat, Orkney Islands)

Speak through the chair, please.

A number of members have requested to ask supplementary questions, which will need to be brief.

Elena Whitham (Scottish National Party, Carrick, Cumnock and Doon Valley)

Forestry and Land Scotland is a key institution in relation to Scotland’s land management. What role does the Government envisage that FLS will play in the next chapter of Scotland’s land reform journey as we strive to ensure that our land benefits the country as a whole, not just a privileged few?

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

Over the past five years, Forestry and Land Scotland has worked with community groups that want to be more involved in managing Scotland’s national forests and land. The community asset transfer of national forests and land has been integral to the creation of businesses, tourism and recreational opportunities and to the establishment of affordable housing, woodland crofts and community renewable energy schemes, with 25 transfers having been completed to date.

Asset transfer has also empowered communities to address challenges with rural housing and to create new woodland crofts and affordable housing. Communities have benefited from renewable energy developments on national forests and land through community benefit payments from large-scale wind farm creation, for example, which has created substantial funds for local communities to draw on.

Mark Ruskell (Green, Mid Scotland and Fife)

Under the Land Reform (Scotland) Bill, will large FLS land holdings be required to produce publicly accessible land management plans for consultation, thereby bringing much-needed scrutiny by communities and other stakeholders?

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

I am not quite sure what Mark Ruskell is asking. As far as I am aware, Forestry and Land Scotland is already publicly accessible. If that is not a full enough answer, I ask Mark Ruskell to come back to me, and I will ask the cabinet secretary to write to him.

Willie Rennie (Liberal Democrat, North East Fife)

Government ministers have repeatedly said that we need to have the right trees in the right places, but farmland in my constituency has recently been bought for tree plantation even though it is useful for food production. Will the minister use any more controls to ensure that we truly get the right trees in the right places?

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

As Willie Rennie said, I have consistently said that we should have the right trees in the right places, but I should point out that it is farmers who sell the land to plant trees in the first place. If we bring in controls at a later date, that will be done through the Land Reform (Scotland) Bill, which is being taken forward by the cabinet secretary.

Richard Leonard (Labour, Central Scotland)

To ask the Scottish Government what its position is on whether the forestry grant scheme is fit for purpose. (S6O-03390)

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

The forestry grant scheme has consistently delivered the positive outcomes that are set out in the Scottish rural development programme. Since 2015, 85,000 hectares of new woodland have been supported, including 40,000 hectares of native woodland and 8,000 hectares through natural regeneration. The forestry grant scheme also contributes to a broad range of other priorities, including public access to woodland, rainforest restoration, priority species conservation and rural development.

Under the Scottish rural development programme, a formal evaluation of the forestry grant scheme from 2015 to 2023 is under way, and the report will be published during 2024.

Richard Leonard (Labour, Central Scotland)

Three weeks ago, I wrote to the cabinet secretary about the revelation that the private global investment company abrdn was paid a public grant of £2.5 million from Scottish Forestry in August 2023 for planting trees in the Cairngorms, even though the company increased its shareholdings in coal and oil and gas corporations in the US by £234 million in the same year. Last week, I received a reply from the cabinet secretary in which she told me:

“Scottish Forestry does not restrict funding to companies based on their wider business interests.”

What is the moral justification for that? Does the minister think that that is right? Why is this Government so soft on corporations and so tough on everybody else?

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

I am not entirely convinced that that is correct, but I will get a much fuller answer to Richard Leonard, and I am happy to meet him to talk about such issues.

Finlay Carson (Conservative, Galloway and West Dumfries)

Today, the issue is not so much whether the right tree is in the right place, but whether we have the right minister in the right place.

In February, the Minister for Energy and the Environment said that

“other sources of funding for tree planting”—[Official Report, 1 February 2024; c 9.]

would be increased to make up for the savage £32 million cut to the forestry grant scheme. What other sources of funding for new woodland creation does the Minister for Agriculture and Connectivity expect to become available? Specifically, how many additional hectares does he believe that that funding will deliver in the coming financial year?

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

The honest answer to that is that I do not know. I am answering questions on behalf of the Cabinet Secretary for Rural Affairs, Land Reform and Islands, and I do not have the answer to that question, but we will write to the member with a suitable answer.

Rachael Hamilton (Conservative, Ettrick, Roxburgh and Berwickshire)

On a point of order, Presiding Officer. I seek your guidance. We are here for rural questions, but we have had not one answer other than the scripted ones. Could the cabinet secretary not have come to rural question time and then dealt with whatever she had to do following that, given that she has been seen on social media at Bute house?

Liam McArthur (Liberal Democrat, Orkney Islands)

I thank Rachael Hamilton for her point. She will be aware that the content of ministerial responses and, indeed, whom the Government chooses to respond to questions are matters for the Government.

Craig Hoy (Conservative, South Scotland)

To ask the Scottish Government what Forestry and Land Scotland is doing to deliver economic benefit from the land that it manages, including through supporting mountain bike tourism. (S6O-03391)

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

Forestry and Land Scotland is the custodian of the nation’s forests and woodlands, and it recently marked the fifth anniversary since it was formed by this Government. The agency’s works in our forests and woodlands represent at least 40 per cent of the total forestry activity in Scotland and contribute some 10,347 full-time equivalent forestry jobs and £382 million in gross value added to Scotland’s economy.

We also host enough renewable energy infrastructure to produce more than 1 billion watts of energy, which is sufficient to power 600,000 homes.

FLS is a key partner in delivering the “Strategy for Scottish Mountain Biking 2023-2025”. Our forests and woodlands welcome 11 million visitors annually across Scotland, of whom 8 per cent are mountain bikers. In the Scottish Borders, that figure increases to 33 per cent.

The “Glentress Masterplan” resulted in a £6 million public investment in trails and car parks. Other master plans are either in development or have been developed for other sites. Those plans act as frameworks for investment; for example, they helped to inform the £5 million 7stanes redevelopment project in the Borderlands growth deal.

Forestry and Land Scotland is also actively working with the Developing Mountain Biking in Scotland project, trail associations and event organisers across Scotland to support mountain biking.

Craig Hoy (Conservative, South Scotland)

I recently met—unlike the minister, clearly—with businesses that represent mountain biking groups that use Glentress mountain biking trails, which are owned and operated by Forestry and Land Scotland. Following last year’s UCI championships, they are concerned that the positive outcomes that were promised from the event have so far failed to materialise or have not fully materialised. The trails at Glentress are partially closed, and the master plan has apparently stalled.

If the minister is still in post at the end of the day, will he join me in urging Forestry and Land Scotland to work with local stakeholders, including Scottish Borders Council, and with the local businesses and community groups that form community trail advocacy in the Tweed Valley, to ensure that they secure a positive economic, social and tourism benefit from last year’s championships.

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

I see that Craig Hoy is clearly looking for the collegiate approach that we are trying to get across the chamber, but it is obviously not working.

Forestry and Land Scotland works with a number of partners on use of volunteers for management of cross-mountain bike trails. I will always be happy to meet stakeholders to see how we can advance things.

Rhoda Grant (Labour, Highlands and Islands)

Forestry and Land Scotland should be looking at providing health benefits as well as economic benefits. As the minister will know, many people like to walk and cycle in the forests, but Forestry and Land Scotland has imposed parking charges that are putting a lot of people off. Will he consider a review of that policy to ensure that everyone has equal access to our forests?

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

The straight answer to that is yes. I will have a look at that and get back to Rhoda Grant.

Graham Simpson (Conservative, Central Scotland)

To ask the Scottish Government whether it will provide an update on what steps it is taking to protect the welfare of wild bees. (S6O-03392)

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

The Scottish Government is committed to halting and reversing the declines in wild bee populations. The “Pollinator Strategy for Scotland 2017-2027” sets out the actions that we are taking to address the pressures that are experienced by wild bees, including creating and restoring habitats for those species. We provide updates on those actions in the strategy’s annual progress reports.

Through the nature restoration fund, we are supporting projects that restore and enhance habitats for our pollinators. That includes providing more than £200,000 for the Pentland to Portobello greening project, £140,000 for the Tweed project and £89,000 for the Irvine to Girvan nectar network.

Graham Simpson (Conservative, Central Scotland)

I am sure that the minister will agree with me that species-rich grasslands are some of our most biodiverse habitats. They provide a lifeline for wild bees and offer multiple other benefits, including storing vast amounts of carbon. We have seen catastrophic losses of those habitats, however. If the Scottish Government values Scotland’s grasslands as it values peatlands and woodlands, would it be willing to develop a national grasslands action plan?

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

I absolutely take on board the point that the member makes about species-rich grass. I used to plant it for exactly the reasons that he has mentioned. There are areas of the Agriculture and Rural Communities (Scotland) Bill, which is currently going through Finlay Carson’s and Rachael Hamilton’s hands, that will address environmentally friendly issues in order to help pollinators. I am happy to discuss that further with Graham Simpson.

Alasdair Allan (Scottish National Party, Na h-Eileanan an Iar)

What steps is the Scottish Government taking to deal with the threat that is posed to Scotland’s bees by the parasitic Varroa mite?

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

In 2022 we updated “The Honey Bee Health Strategy 2022-2032”, which aims to address the challenges that are facing honey bees and beekeepers. The strategy is supported by an implementation plan that details a number of actions specifically aimed at minimising the spread of Varroa, under the auspices of the dedicated Varroa working group. Those include activities to protect the precious few remaining Varroa-free areas.

We are also providing funding for the apiculture specialists at Scotland’s Rural College, who provide education and a support service for beekeepers, focused on disease prevention, good biosecurity and treatment for Varroa mites.

Mark Ruskell (Green, Mid Scotland and Fife)

I declare an interest as a beekeeper, and I should also mention that I am the new species champion for the moss carder bee, which is one of Scotland’s rarest bee species.

Too often, conservation funding is very time limited. What long-term support is available for conservation programmes to secure the future of rare pollinator species such as the moss carder bee?

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

Clearly, I cannot give any commitments today. However, as I have said, the Agriculture and Rural Communities (Scotland) Bill is going through stage 2 at the moment. The Scottish Government is clearly seeking to protect pollinators through all the pollinator strategies that we currently have.

Liam McArthur (Liberal Democrat, Orkney Islands)

Question 6 has been withdrawn.

Fergus Ewing (Scottish National Party, Inverness and Nairn)

To ask the Scottish Government what discussions the Cabinet Secretary for Rural Affairs, Land Reform and Islands has had with ministerial colleagues regarding undertaking an immediate review of the Water Environment (Controlled Activities) (Scotland) Regulations 2011, in order to allow proactive watercourse management to assist farmers, crofters and land managers to protect agricultural land from flooding risks themselves. (S6O-03394)

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

I continue to work with my Cabinet colleagues to ensure that Scotland has a sustainable water resource for food production, energy and drinking water. I recently convened a water resource planning round table, which highlighted the need to manage both water excess and scarcity in the face of a changing climate.

While watercourse management can play a role, it is not always effective in reducing water levels, and it can have an impact on downstream populations. We are bringing environmental regulations, including the Water Environment (Controlled Activities) (Scotland) Regulations 2011, into an integrated authorisation framework, and facilitating a clear process for applications.

Fergus Ewing (Scottish National Party, Inverness and Nairn)

That sounded a bit like a “No”.

I will cite one farmer, who told me that

“Farmers and landowners must be allowed to clear riverbanks and in some cases dredge rivers. SEPA stops them at every turn.“

I have spoken to three other farmers who have identified an overly complex prescriptive system, and they say that they are rarely allowed to remove silt and only use bank protection such as gabion baskets for insufficient lengths of time to avoid resultant flooding. They say that damage is being done to public roads, for example the B740. In some cases, farmers are actually threatened by SEPA with withdrawal of their single farm payments, for infraction, so that many farmers are afraid to have sheep on their farm. Is not the system a complete failure?

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

No, I do not believe that the system is a complete failure. There is a complete dichotomy between what farmers are asking SEPA to do and what SEPA believes should be done. SEPA does not ban dredging.

Land managers can undertake certain works without the need for SEPA authorisation, including clearing subsurface field drains and man-made ditches. Litter debris and in-stream vegetation can also be removed without SEPA authorisation. Regulatory controls are proportionate to the risk, and sediment removal in agricultural ditches and straightened rivers can be carried out under authorisation, which is subject to good practice.

There is absolutely no doubt that we are getting far heavier rainfall and far more surface water coming down. We have to find a way of holding that water back. Last week, I had a conversation with Martin Kennedy from NFU Scotland. The idea is to clear the rivers and get the water down more quickly. However, if the water comes down more quickly, it floods somebody else further down. We need a much more integrated approach to managing our water, in the longer term.

Tim Eagle (Conservative, Highlands and Islands)

As has just been mentioned, that is simply not enough. The minister might be aware that, in Moray, the communities of Garmouth and Kingston have suffered terrible flooding damage to agricultural fields, as well as to homes and businesses. Many locals can remember parents and grandparents entering the river to clear shingle banks, which helped to control the waters of the Spey in years gone by. Will the minister consider changing the regulations to ensure that such local knowledge can be used in the future?

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

I will not give that commitment right now, but I can say to Tim Eagle—I am not saying this to dampen down the debate—that there is an issue with water. Between flooding and drought, we now have a far bigger problem with water; they are much more extreme than they have ever been in the past. Water is not held in the hills with snow, but the upland areas could catch a lot more water. If it can be held up there earlier, we will not get flooding downstream.

Maggie Chapman (Green, North East Scotland)

The minister will be aware of the repeated flooding that residents in Angus have faced during the past nine months or so. What reassurances can he give them that effective watercourse and river-basin management will protect them from flooding in the coming months?

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

The Government is very alive to the fact that those flooding events have taken place; we have put money into the Brechin area in particular. However, the Government is consistently looking at what we are going to do about water management, which is why we held a round-table meeting last week, or the week before.

Neil Bibby (Labour, West Scotland)

To ask the Scottish Government what cross-Government action it is taking to support Scotland’s islands and their economies. (S6O-03395)

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

Scotland’s first national islands plan was published in 2019 to co-ordinate cross-Government actions aimed at improving outcomes for island communities. To date, delivery of the plan has been supported by more than £12 million for critical infrastructure. That is additional to our investments in regional growth deals and our carbon neutral islands project, which further benefit the islands. The islands cost crisis emergency fund, which has already distributed £2.4 million to help island households and businesses, will be worth £5 million in 2024-25. We will publish a second national islands plan next year in collaboration with island communities and local authorities.

Neil Bibby (Labour, West Scotland)

During the past month, the Ardrossan to Brodick ferry route saw 57 cancellations in three days when no ferries sailed at all. The current condition of Ardrossan harbour has led CalMac to claim that it can no longer berth overnight because of the risk of damage to vessels, which means that it can no longer operate the first sailing of the day. That is having a significant impact on the local economy, deliveries and workers. CalMac and Peel Ports are pointing fingers at each other while the multimillion-pound upgrade that was approved six years ago has been paused. Will the Scottish Government use its influence to get all parties around the table to ensure that people travelling between Ardrossan and Brodick have a reliable ferry service?

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

I fully take on board the member’s point. I know that the Cabinet Secretary for Rural Affairs, Land Reform and Islands is keen to ensure that we get people around the table to find a solution so that this brilliant island community, which has so much resource going for it, gets a solution to get the ferries back on course.

Kenneth Gibson (Scottish National Party, Cunninghame North)

I am pleased to say that there is an Ardrossan harbour task force meeting next week.

Arran’s business community faces additional challenges this summer because of reduced ferry capacity and heightened disruption from the closure by Peel Ports of Ardrossan’s Irish berth. However, despite the negative media caricatures of the island, Arran remains open for business. How can the Scottish Government and CalMac promote that message? What practical assistance is being offered to minimise the impact of disruption on the viability and sustainability of Arran’s businesses?

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

I take on board the point that Kenneth Simpson regularly makes for his constituents.

George Adam (Scottish National Party, Paisley)

Gibson.

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

Kenneth Gibson. The Scottish Government is consistently looking to ensure that people understand that all our island communities are open and that they are brilliant destinations.

Jamie Halcro Johnston (Conservative, Highlands and Islands)

On 13 March, I asked the minister in this chamber whether a derogation to the North Sea cod avoidance plan in order to allow fishing for squid inside 12 nautical miles—which is extremely important for the Shetland fishing industry and its local economy—would be considered. The minister said that the matter was one for the cabinet secretary, and that he would ask her to respond to me directly. Nearly two months later, I have still not received a reply from the cabinet secretary. Is such a derogation being considered? Has the idea been rejected, or has it been accepted?

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

I will chase that up with the cabinet secretary and get back to the member.

Beatrice Wishart (Liberal Democrat, Shetland Islands)

What engagement has the Scottish Government had with the United Kingdom Government about developing short subsea tunnels between some of Shetland’s islands? May I request that, if the minister is unable to answer, he provides a response in writing?

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

I will definitely provide a response in writing, but I can tell Beatrice Wishart that I have met the Shetland Islands community to talk about the issue, which she has raised previously with me. I will be happy to give her a response in writing.

Liam McArthur (Liberal Democrat, Orkney Islands)

The next portfolio is NHS recovery, health and social care. I remind members that questions 2 and 7 are grouped together, so I will take any supplementaries on those questions after both have been answered. Anybody who wishes to ask a supplementary question should press their request-to-speak button during the relevant question. Again, there is a lot of interest in supplementaries, so the questions and, indeed, the responses will need to be brief.

Jackie Baillie (Labour, Dumbarton)

To ask the Scottish Government what value it places on specialist alcohol services, such as the primary care alcohol nurse outreach service in Glasgow, in dealing with the reported public health crisis in relation to alcohol. (S6O-03396)

Jenni Minto (Scottish National Party, Argyll and Bute)

The Scottish Government values all initiatives and actions that are taken to help to address the public health crisis in relation to alcohol. Specialist services play a key part in helping to address that emergency, and initiatives such as the primary care outreach nurse service help to deliver co-ordinated and person-centred assessment, advice and care for people who have been impacted by alcohol.

Jackie Baillie (Labour, Dumbarton)

Last week, the Glasgow alcohol and drug partnership decided to downgrade the alcohol nurse outreach service by transferring it to a more generic drugs and alcohol service. That was done as a result of Scottish National Party cuts to the primary care budget. Does the minister accept that there is a need to ensure parity of response for alcohol and drug addictions, and will she ensure that the most vulnerable people with alcohol addiction in areas of the greatest deprivation in Glasgow are not let down by that decision?

Jenni Minto (Scottish National Party, Argyll and Bute)

As Jackie Baillie pointed out, the decision has been taken to amalgamate the alcohol nurse outreach service, which was a pilot that was set up by the health and social care partnership, into the alcohol and drugs recovery service. That will bolster an existing very successful service with nurses. That service is already accessed not only by people who have a drugs issue but by people who have an alcohol issue. According to the information that I have received, it is a good service that will absolutely support people who are in need of such holistic care.

Bill Kidd (Scottish National Party, Glasgow Anniesland)

Can the minister provide an update on what action the Scottish Government is taking to reduce health inequalities when it comes to alcohol-related harm?

Jenni Minto (Scottish National Party, Argyll and Bute)

The Scottish Government is determined to do all that it can to reduce alcohol-related harm. We continue to implement actions that are outlined in our alcohol framework, which have a strong focus on reducing health inequalities, protecting children and young people, and building on existing measures to change Scotland’s relationship with alcohol. Those include our world-leading minimum unit pricing policy, which, the evidence suggests, has contributed to reducing health inequalities, as the largest estimated reductions in deaths attributable wholly to alcohol consumption have been in men and those who live in the 40 per cent most deprived areas. Alongside MUP, we continue to invest in treatment and a wide range of other measures, including funding for alcohol and drug partnerships, which rose to a record £112 million in 2023-24.

Sue Webber (Conservative, Lothian)

To ask the Scottish Government what action it is taking to support NHS Lothian in reducing the CAMHS waiting lists across the region. (S6O-03397)

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

We continually monitor child and adolescent mental health services waiting times performance and engage with all health boards, including NHS Lothian, and direct tailored support to those with the longest waits, providing access to professional advice. We commissioned health boards to submit performance trajectories up to March 2025, which will be updated annually and used to continue targeted improvement work, ensuring that all boards consistently meet the CAMHS standard. Boards were allocated £55.5 million in 2023-24 via the mental health outcomes framework to improve the quality and delivery of mental health services for all, in addition to the core funding that health boards receive.

Sue Webber (Conservative, Lothian)

One of my constituents is only eight years old and has been on the neurodevelopmental waiting list for an assessment for attention deficit hyperactivity disorder for 96 weeks already. The frustration and the distress that the family is experiencing because of that wait are unacceptable. Despite the school being supportive and offering my constituent one-to-one adult support, he continues to have outbursts that the family is finding difficult to manage.

I have already raised that case with you, minister, and you advised me to contact NHS Lothian. I had already done so prior to contacting you, as had the family—

Liam McArthur (Liberal Democrat, Orkney Islands)

Speak through the chair.

Sue Webber (Conservative, Lothian)

That is hardly a tailored response. The family has been waiting almost two years for only an assessment and contacted me as a last resort. What action should the family take next in the face of those unacceptable waiting times?

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

We are working closely with national health service health boards and local authorities to improve services and support for children and young people and their families. We will continue to ensure that long waits are appropriately addressed.

We are supporting boards to implement the national neurodevelopmental specification. As part of that, we have provided more than £1 million to fund five pilots, which focus on implementing various aspects of the specification, including getting it right for every child and multi-agency working. We intend to revisit the neurodevelopmental specification to ensure that it continues to be relevant and meets the needs of children and their families. That will involve reviewing learning from those who are implementing the neurodevelopmental specification to date and understanding how we can better measure that. We will support health boards and local authorities to work together, in line with that specification, to ensure that the support is there for the children who need it, regardless of whether they have a diagnosis.

Pam Duncan-Glancy (Labour, Glasgow)

To ask the Scottish Government whether it will provide an update on what measures it is putting in place to reduce waiting times for access to CAMHS. (S6O-03402)

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

In my answer to Sue Webber, I set out how we monitor the performance of child and adolescent mental health services, engaging regularly with all health boards. The CAMHS specification was published in February 2020, setting out the level of service that children, young people and families can expect from CAMHS across Scotland.

It is really positive to see the significant and sustained improvement in CAMHS waiting times over the past year. Most notably, national performance against the 18-week CAMHS standard is the fourth highest since records began and the highest achieved since the quarter that ended in March 2016.

Pam Duncan-Glancy (Labour, Glasgow)

So far, the Government has still failed to meet the target of 90 per cent of children and young people being seen by CAMHS in 18 weeks, and one in four are turned away, which not only impacts access to support for their mental health but has an impact on pupils having their needs met in schools, as evidence to the Education, Children and Young People Committee suggests.

Does the minister agree that delays to healthcare that impact education are unacceptable? What conversations has she had with the Cabinet Secretary for Education and Skills on improving joined-up working?

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

Pam Duncan-Glancy will be aware that we operate the policy of getting it right for every child. It is not necessary to wait for a health diagnosis to put in place support in schools. A delay in accessing healthcare should not delay access to the support that is required to fulfil a child’s right to education. That is really important for people to understand.

Pam Duncan-Glancy mentioned rejected referrals. That language is difficult for me to accept. It is important that we consider that many of those referrals are inappropriate and that people are redirected to more appropriate support for them rather than receiving an outright rejection. That is not a denial of the difficult situation that children are in; it is simply signposting towards more appropriate support than CAMHS, which is a specialist mental health service.

Liam McArthur (Liberal Democrat, Orkney Islands)

There are a couple of supplementary questions. They will need to be brief, as will the responses.

Audrey Nicoll (Scottish National Party, Aberdeen South and North Kincardine)

Will the minister provide any further update regarding the latest assessment of CAMHS waiting lists and how they compare with last year’s?

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

As I have said a number of times in the chamber, we are seeing positive signs of improvement across the waiting lists compared with last year. The statistics that were published on 5 March 2024 show that overall CAMHS waiting lists decreased by 27 per cent from the previous year, the number of children waiting for more than 18 weeks decreased by 53 per cent from the previous year and the number of children waiting for more than 52 weeks decreased by 74 per cent from the previous year. We remain committed to supporting all boards to meet the standard that 90 per cent of patients start treatment within 18 weeks of referral.

Paul Sweeney (Labour, Glasgow)

NHS Scotland’s waiting times stipulate that children and young people should only be removed from the CAMHS waiting list once they have attended an initial appointment and, where appropriate, when treatment has commenced. However, some health boards are removing people from the CAMHS waiting list simply when an appointment date is received. What is the Government doing to ensure that health boards are removing people from the CAMHS waiting list only once they have started treatment?

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

Accuracy of data in the mental health system is absolutely crucial to understanding the countrywide situation that we face and the means by which we should tackle the challenges that we face. I would be more than happy to meet Paul Sweeney to discuss in more detail what exactly is happening not just with the CAMHS waiting list but with other waiting list targets to ensure that we are working on accurate data making accurate progress.

Tim Eagle (Conservative, Highlands and Islands)

To ask the Scottish Government whether it will provide an update on what steps it is taking to improve ambulance turnaround times. (S6O-03398)

Jenni Minto (Scottish National Party, Argyll and Bute)

The Scottish Ambulance Service continually engages with health boards while optimising services including flow navigation centres and the integrated clinical hub, which provide care for patients at or near home, thereby reducing pressures on accident and emergency departments. The call before you convey protocol is being used, and cohorting areas have been established at challenging sites, ensuring that ambulance crews are freed up during high-demand periods.

Tim Eagle (Conservative, Highlands and Islands)

It is a matter of life and death that ambulances are ready and able to swiftly respond to emergency calls, so it is alarming that we regularly hear reports of ambulances stuck outside A and E departments. Average turnaround times regularly exceed 45 minutes, and we have reports from A and E staff, consultants and general practitioners that sick patients who need a hospital transfer are waiting hours and hours for an ambulance. Does the minister recognise that that is happening on the Scottish National Party’s watch and that it is placing huge strain on our key national health service workers? Will she ensure—with all her energy—that hospitals have the beds, space and resources available to ensure quick turnaround times for our ambulances?

Jenni Minto (Scottish National Party, Argyll and Bute)

I thank Tim Eagle for his question and recognise that we have to ensure that ambulance turnarounds are as quick and safe as possible. We have many examples of where work on that is being done, and the Government has regular meetings with the health boards to discuss what they are doing and where there might be blockages. For example, NHS Grampian has established an area with six overspill beds, which has been robustly staffed over the past month and is available over a 24-hour period.

Carol Mochan (Labour, South Scotland)

Figures that were obtained by Scottish Labour for my region show that the longest turnaround times for ambulances at Ayr hospital and Dumfries and Galloway royal infirmary were more than 24 hours. In addition, waits of well over an hour have been recorded for critical purple-code call-outs. Does the minister agree that, although our paramedics and NHS staff are working hard and are under pressure, this Government’s mismanagement of the NHS is failing patients and staff? Will the minister explain what work—beyond holding meetings—it will do collaboratively across the NHS to address the pressures on ambulance services?

Jenni Minto (Scottish National Party, Argyll and Bute)

Patient safety remains our top priority, and I apologise to anyone who has experienced a wait for an ambulance team to reach them. The Scottish Ambulance Service is currently reviewing 2024-25 recruitment plans to reflect the expansion of innovative services such as flow navigation centres and the integrated clinical hub, which aim to provide as much care as possible for patients at home or close to home without conveying them to hospital. That is one action that we are taking.

It is important to understand where the pressures are and find the right solutions to them, and that is what the Scottish Government is committed to doing.

James Dornan (Scottish National Party, Glasgow Cathcart)

To ask the Scottish Government whether it will provide an update on the work that is under way to support people to have more choice and involvement in how their social care is delivered. (S6O-03399)

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

It is vital that people can make informed choices and that they have control over how their social care is delivered, through self-directed support. That is why, in April, as part of the self-directed support improvement plan, we relaunched the support in the right direction programme. Over three years, £9.9 million will provide independent support, advice and advocacy to help people to access the care that they want.

Also in April, we reopened the independent living fund to new applicants. An initial £9 million investment will help up to 1,000 additional disabled people with complex needs to arrange the care that they need to live more independently.

James Dornan (Scottish National Party, Glasgow Cathcart)

I welcome the additional investment of £9 million for the support in the right direction programme. Will the minister expand on how the programme enables organisations to deliver independent support and advocacy to help people to live independently and participate in all aspects of life?

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

The programme was launched by the Scottish Government in 2018 with the aim of increasing the delivery of independent support to people who need social care. In 2023, we agreed to fund the multiyear programme from 2024 to 2027 with £3.3 million per year. The programme is delivered through partnership agreements with third sector organisations in local authority areas across Scotland. Currently, 33 organisations across all 32 local authority areas in Scotland are funded by the Scottish Government. Those organisations provide advocacy, brokerage, information and social care planning services to people who need them.

Elena Whitham (Scottish National Party, Carrick, Cumnock and Doon Valley)

To ask the Scottish Government what support it is providing to NHS Ayrshire and Arran to improve access to ADHD testing for adults. (S6O-03400)

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

The Scottish Government recognises that more needs to be done to support neurodivergent adults, including those with attention deficit hyperactivity disorder. Although it is the responsibility of local areas to provide support and services, we are taking a range of supportive actions.

We provided £650,000 for adult neurodevelopmental pathways pilots in 2022-23. Following the pilots, we are funding and working with the national autism implementation team—NAIT—to take forward the recommendations of its 2023 report. Support from NAIT is being given directly to health and social care partnerships to develop action plans, introduce adult neurodevelopmental pathways and provide professional learning workshops. We are funding a new neuro-affirming community of practice, which was launched in October 2023, and there has been positive engagement across health boards with that. We are publishing guidance on shared care and prescribing ADHD medication to adults following private sector diagnosis, and we are providing £1 million annually for the autistic adult support fund—AASF—which offers support that is not diagnosis dependent to people who have autism, many of who will also have ADHD.

Elena Whitham (Scottish National Party, Carrick, Cumnock and Doon Valley)

As the constituency MSP for Carrick, Cumnock and Doon Valley, I have received many requests from adults who are looking for support to access ADHD testing. They recognise that the difficulties that they have faced throughout their entire adult life are symptoms of ADHD. Many have faced multiple challenges, including difficulty in maintaining employment or relationships, and periods of incarceration or self-medication. Given the advice that NHS Ayrshire and Arran has insufficient capacity in existing services to assess and treat in a timeous manner, I would be grateful for the minister’s advice and any information on what the Scottish Government can do to assess that health board and other health boards.

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

I have made inquiries with NHS Ayrshire and Arran about the actions that it is taking to address waiting times, and we have offered support from the national autism implementation team. I understand that the chief officers received a report in February and are currently considering their next steps.

Nationally, we continue to look at how best to develop and support single neurodevelopmental pathways for adults, working with NAIT, local health and social care partnerships and NHS boards. Additionally, there is a NAIT facility and an adult neurodevelopmental professionals network, which I am aware that NHS Ayrshire and Arran is part of.

We are committed to working together to improve the position for individuals and their families and to ensure that people can access support when they need it.

Alasdair Allan (Scottish National Party, Na h-Eileanan an Iar)

To ask the Scottish Government whether it will provide an update on how the NHS supports the health of rural and islands communities through regular visits from consultants. (S6O-03401)

Jenni Minto (Scottish National Party, Argyll and Bute)

The Government recognises the importance of ensuring equitable access to healthcare for patients in rural and island communities. Individual boards and integration authorities are responsible for planning and delivering services to meet the needs of their communities. That includes understanding the needs of their populations and designing services that can deliver high-quality care. It requires a variety of approaches, including local delivery where possible and, where more appropriate, supporting patients to access specialist facilities.

Alasdair Allan (Scottish National Party, Na h-Eileanan an Iar)

My constituents in Uist are concerned that recent flight timetabling is understood to have prevented some visits by consultants from Raigmore hospital in Inverness. Can the minister indicate what can be done to ensure that the timetabling of transport links is harmonised, giving due consideration to the needs of island communities, to ensure that the level of healthcare to which islanders should be entitled is not detrimentally affected?

Jenni Minto (Scottish National Party, Argyll and Bute)

As an inhabitant of an island, I recognise the pressures that Alasdair Allan talks about. The Scottish Government recognises that more can be done to bring transport planning and health service planning together. However, the timetabling of commercial flights is a matter for the airlines involved.

In 2023, we prepared the draft transport to health plan and we have been working with regional transport partnerships and other partners to deliver the commitments. The Highlands and Islands Transport Partnership recently convened a meeting of health boards in its area to discuss the establishment of a health and transport action plan, and this issue is exactly the type of thing that the action plan should be considering.

Douglas Ross (Conservative, Highlands and Islands)

The question mentions rural healthcare, which allows me to ask about the campaign to reopen the Burghead and Hopeman surgeries. The minister sat through a debate that I held on 21 March and the Government gave commitments that the Evan Beswick review would be published imminently, but the review has still not been published. Jenni Minto promised to meet the save our surgeries campaigners, but they have still not been offered a meeting and have said today that they are being kept in the dark. When can we see the Evan Beswick review and when will Jenni Minto meet the save our surgeries campaigners?

Jenni Minto (Scottish National Party, Argyll and Bute)

It was a pleasure to meet the member’s constituents, who have been campaigning hard for the re-establishment of their general practitioner surgeries. I will check to find out when the Evan Beswick report will be published. I will also chase up my diary, if I remain in this role, and hopefully get the meeting booked as soon as possible, as I have connections to Moray.

Rhoda Grant (Labour, Highlands and Islands)

I urge the minister to have that meeting as soon as possible, because the matter is urgent. Could I also ask her to have a meeting with Western Isles Council and the health board? Due to budget cuts, the council has changed its subsidised air service provider and the aircraft that is now being used to go from Uist to Stornoway to access consultants is not accessible to anyone with mobility issues, so our disabled people and elderly people are not able to see a consultant in Stornoway. Therefore, can I urge the minister to take that action?

Jenni Minto (Scottish National Party, Argyll and Bute)

I am concerned about what Rhoda Grant has reported with regard to access for elderly and less mobile constituents of hers. I would be happy to chase that up and respond to her in writing.

Alexander Stewart (Conservative, Mid Scotland and Fife)

To ask the Scottish Government what steps it is taking to ensure good dental care provision for older people in care settings. (S6O-03403)

Jenni Minto (Scottish National Party, Argyll and Bute)

Building on the recommendations of the 2018 oral health improvement plan, a bespoke training and mentoring programme was introduced in 2019 to establish a new programme of enhanced domiciliary dental care, supported by regulation changes. Under those arrangements, independent dentists are provided with specific training that allows them to be accredited to provide dental care to people who are living in care homes.

The overall aim of the programme is to ensure that the appropriate service providers—sorry. The overall aim is to ensure that the appropriate service provides the appropriate care in the appropriate setting—there were too many appropriates there—allowing the public dental service to concentrate on more complex domiciliary care and treatment.

Alexander Stewart (Conservative, Mid Scotland and Fife)

Under changes that were introduced late last year, elderly residents in care settings are seeing the frequency of dental check-ups halved and dentists who see multiple patients on a single visit are being financially punished for their efficiency. Dental practitioners have contacted Scotland’s chief dental officer outlining those concerns and proposing a fair solution. Will this Government embrace that fair solution?

Jenni Minto (Scottish National Party, Argyll and Bute)

After receiving feedback, we recently consulted the sector on the issue. As a result, last month we introduced an amendment to the statement on dental remuneration, which allows enhanced skilled practitioners to claim the regular domiciliary fee in addition to the item of service treatment payment and the enhanced skills care and treatment allowance. That means that enhanced skilled practitioners are now able to claim an additional £89.05 for every care home visit. I think that that example shows that the Scottish Government is listening to dentists.

Willie Rennie (Liberal Democrat, North East Fife)

This week, the British Dental Association said:

“We just can’t recruit. We have enough dentists but we don’t have enough that want to work in the NHS.”

Does the minister recognise that our new fee system is just not working? What is she going to do about it?

Jenni Minto (Scottish National Party, Argyll and Bute)

I disagree with the premise of Willie Rennie’s question. The new fee system was introduced only in November, and we are still working through it. As the member will know, if all things remain equal, we will have a round-table meeting tomorrow in the Parliament to discuss dental services. It is important to recognise that the Scottish Government is also considering a range of workforce initiatives, including looking at how we can better utilise dental therapists to provide national health service care.

This is not just an issue that affects Scotland, so I have met my counterparts in other United Kingdom nations to discuss how we can improve the pipeline for overseas dentists to work in the UK. I am pleased that the Westminster Parliament is looking at the issue.

Sandesh Gulhane (Conservative, Glasgow)

There are 140 care homes in Glasgow. For many residents, domiciliary dental care is vital.

I visited Woodside dental practice, where 96 per cent of patients are receiving NHS treatment. The practice operates care-at-home services, with more than 1,000 residential patients, and its dentists have advanced training. It has said that the Scottish National Party is not listening to dentists. It finds that, under determination 1, the financials simply do not work. Payments have been cut by a third, and it will be forced to end the care-at-home service before the end of May.

Will the minister commit to tackling this latest crisis in NHS dentistry, or will the SNP let this vulnerable—

Liam McArthur (Liberal Democrat, Orkney Islands)

Minister.

Jenni Minto (Scottish National Party, Argyll and Bute)

I thank Sandesh Gulhane for his question. As I said in my response to his fellow Conservative MSP, Alexander Stewart, we have listened to feedback. We have consulted the sector and have changed the fee for dental remuneration.

James Dornan (Scottish National Party, Glasgow Cathcart)

Can the minister provide an update on what assessment the Scottish Government has made of the number of NHS dentists in Scotland and how that compares to elsewhere in the UK?

Jenni Minto (Scottish National Party, Argyll and Bute)

NHS Education for Scotland provides regular data on NHS dental workforce head count. The long-term trend is positive, with the number of high street NHS dentists increasing by almost a quarter from September 2007 to September 2023. We have maintained a strong track record in growing the NHS dental workforce in Scotland, with 57 dentists per 100,000 of the population, compared with 42 in England and 46 in Wales.

Liam McArthur (Liberal Democrat, Orkney Islands)

That concludes portfolio questions on NHS recovery, health and social care. There will be a brief pause before we move to the next item of business, to allow front-bench teams to change position.

Annabelle Ewing (Scottish National Party, Cowdenbeath)

The next item of business is portfolio questions on social justice. Should a member wish to ask a supplementary question, they should press their request-to-speak button or, if they are online, enter the letters RTS in the chat function during the relevant question.

Elizabeth Smith (Conservative, Mid Scotland and Fife)

To ask the Scottish Government whether it will provide an update on the rural affordable homes for key workers fund. (S6O-03404)

Paul McLennan (Scottish National Party, East Lothian)

I recognise the importance of good-quality affordable homes, including those for key workers, to attract and retain people for the benefit of our rural and island communities. I know that a number of local authorities are actively looking to bring forward proposals under the demand-led fund and that four affordable homes have already been approved in Orkney. I have written to all local authority chief executives to encourage collaborative working between authorities and relevant partners. I am engaging with local authorities and others, including business interests, to maximise uptake of the fund.

Elizabeth Smith (Conservative, Mid Scotland and Fife)

I suppose that having four homes in Orkney is better than zero homes, which is the figure that my colleague Miles Briggs was given when he asked the same question about the £25 million fund six months ago. Does the minister accept that that situation is entirely unacceptable, given the pressure that the rural sector faces when it comes to attracting the workers that it needs? John Swinney highlighted that in his interview in The Courier, which was published this morning. In light of the collapse of the Bute house agreement, will the needs of our rural communities finally become a priority?

Paul McLennan (Scottish National Party, East Lothian)

They are a priority. I have visited a number of local authority areas, including Orkney, as I mentioned, as well as Shetland and the Western Isles to talk about that. We have written to and contacted chief executives about the subject. It is important that local authorities take that forward and take a strategic overview. Mr Lochhead and I met key stakeholders in Perth just before Christmas, and I have a follow-up meeting.

As I said, the fund is demand led, and I am happy to meet Liz Smith to discuss the issue further. We have made a number of interventions with local authorities to ask them to ensure that they are working strategically with key partners to deliver the demand-led service.

Willie Rennie (Liberal Democrat, North East Fife)

To ask the Scottish Government what impact the ending of the Bute house agreement will have on the Housing (Scotland) Bill. (S6O-03405)

Paul McLennan (Scottish National Party, East Lothian)

The Housing (Scotland) Bill was introduced on 26 March 2024. If passed by Parliament, the bill will enable the delivery of our commitments for longer-term private sector rent controls; tenants’ rights and other protections; duties aimed at the prevention of homelessness; and supporting social rented sector tenants who are experiencing domestic abuse.

I will continue to engage with stakeholders. Of course, Parliament will determine the timetable on which the bill will proceed. We will work constructively with all members to support the passage of the bill.

Willie Rennie (Liberal Democrat, North East Fife)

The ending has had no effect whatsoever—that is how I read that. I have repeatedly said that, if we are to take the significant step of introducing rent controls, we need evidence of the impact of the current and previous arrangements. There is a real danger that rent controls will create a rent floor rather than a rent ceiling. Is the minister absolutely confident that he has sufficient evidence before proceeding with the bill?

Paul McLennan (Scottish National Party, East Lothian)

I am confident. As part of the bill process, we will be taking evidence. The bill will go through the committee stage, when there will be a call for evidence. I would have thought that that would result in stakeholder responses on the issue.

We are confident with what we have just now. As I said, part of the process is to continue to engage with stakeholders, but we will also go through the bill process, which involves calling for evidence.

Annabelle Ewing (Scottish National Party, Cowdenbeath)

We have some supplementaries.

Miles Briggs (Conservative, Lothian)

There is a lot to welcome in the bill, and we have welcomed many parts of it, but rent controls, which are part of the bill, are hugely damaging the market in Scotland. Rent controls have led to a decrease in supply. Some 17 per cent of landlords are saying that they will sell or consider selling their property. Rent controls are also driving up rents, and we have the highest increase in rents anywhere in the United Kingdom. I ask the minister a very simple question: now that the Bute house agreement has come to an end, will he agree to review the bill and work with parties that want to ensure that the bill will help renters in Scotland, not hinder them?

Paul McLennan (Scottish National Party, East Lothian)

Mr Briggs and I have a close relationship when it comes to housing matters, and we meet regularly. When the bill was introduced, we discussed it. I engaged with him and said that we would continue to do that.

On rent controls, as I said, we will continue to listen to stakeholders to get the right balance between getting investment into the sector and protecting the most vulnerable. I am happy to meet Miles Briggs at any time to discuss the bill.

Evelyn Tweed (Scottish National Party, Stirling)

Will the minister outline how the Government plans to proceed with the bill and ensure that its critical measures on tackling homelessness are achieved?

Paul McLennan (Scottish National Party, East Lothian)

If the bill is passed by Parliament, the homelessness duties will help to prevent homelessness before it occurs and ensure that households do not face the trauma and disruption of homelessness. We will work with stakeholders, including those in health and justice, to get the guidance and training right to support the duties and identify the best timing for implementation.

Paul Sweeney (Labour, Glasgow)

In light of the historic decision by Reidvale Housing Association shareholders to reject a takeover by Places for People in recent months, will the minister consider making provision in the bill for enhanced protections for community-based registered social landlords to ensure that they are not unnecessarily taken over, perhaps by raising the threshold for tenant ballots to two thirds, which is the same as that in the Co-operative and Community Benefit Societies Act 2014?

Paul McLennan (Scottish National Party, East Lothian)

Mr Sweeney has raised the issue in the chamber a number of times, and we have had a couple of discussions about it. He will know that housing regulators are also involved in the process but, if I am still in post, I will be happy to meet him again to discuss the matter. As I said, there will be continuous engagement with members throughout the bill process, but I am happy to meet him to discuss it.

Patrick Harvie (Green, Glasgow)

I am pleased that the minister still supports the principle of rent controls, but he will be aware that some people are lobbying for the vested interests of landlords, not tenants, and are seeking to water down those proposals—for example, in relation to between-tenancy rent increases and automatic rent condition assessments. Will he assure us that he will oppose such measures, which, if taken forward, would be as useless as the old rent pressure zones, which have never been in effect anywhere in Scotland? [ Interruption .]

Annabelle Ewing (Scottish National Party, Cowdenbeath)

Before I ask the minister to reply, I ask all members to show courtesy and respect to the member who has the floor—that was not any of the members who were seeking to make sedentary comments.

Paul McLennan (Scottish National Party, East Lothian)

The key thing, as I mentioned in previous answers, is that we will continue to engage with stakeholders and other members. When Mr Harvie was in post, he and I met stakeholders, and I am happy to engage with him as we go through the bill process, to discuss the points that he has raised.

Rona Mackay (Scottish National Party, Strathkelvin and Bearsden)

To ask the Scottish Government, regarding any potential impact on devolved benefits in Scotland, what representation it plans to make to the United Kingdom Government regarding its proposed changes to welfare benefits for people with mental health issues. (S6O-03406)

Paul McLennan (Scottish National Party, East Lothian)

Last week, the Cabinet Secretary for Social Justice sought urgent clarity from the Department for Work and Pensions that people who receive adult disability payment will continue to receive the reserved benefits that they rely on. She has also sought assurances that the UK Government will not seek to impose cuts to expenditure on the Scottish Government.

The Scottish Government will never accept the cruel welfare reforms that are being pursued by the DWP and which further stigmatise and impoverish disabled people. In contrast, in 2024-25, we are committing a record £6.3 billion to benefits expenditure, which is £1.1 billion more than we receive from the UK Government for social security.

Scotland’s social security system is designed on the principles of dignity, fairness and respect. Those are the values of this Government and of the people of Scotland.

Rona Mackay (Scottish National Party, Strathkelvin and Bearsden)

I welcome the minister’s response. Does he agree that the UK Government should look to the Scottish Government model of Social Security Scotland and start treating people with dignity, fairness and respect by scrapping the proposed welfare cuts for people with mental health issues?

Paul McLennan (Scottish National Party, East Lothian)

Yes—I agree with that. The UK Government’s heartless approach to social security appears to be entirely focused on reducing the support to those who need it. Disabled people’s organisations in Scotland have already warned that the UK Government’s planned changes are “cruel, punitive and ineffective” in getting disabled people back into work.

Meanwhile, our compassionate and caring approach, which is fundamentally different from that of the DWP, has been backed by experts. The Scottish Government completely rejects the proposed changes, and I call on the UK Government to halt those plans, so that they can be properly scrutinised.

Jeremy Balfour (Conservative, Lothian)

The minister will recognise that the waiting times for benefits in Scotland are longer than those for DWP benefits. Will he take action so that people who are waiting to hear whether they are entitled to a claim are not left with the stress of waiting for months before they get a response from Social Security Scotland?

Paul McLennan (Scottish National Party, East Lothian)

I know that the member has an interest in the area, and he has raised it with the Cabinet Secretary for Social Justice on a number of occasions. I will engage with her and feed the answer back to Mr Balfour.

Sandesh Gulhane (Conservative, Glasgow)

To ask the Scottish Government whether it will provide an update on its plans to introduce long-term rent controls. (S6O-03407)

Paul McLennan (Scottish National Party, East Lothian)

I refer the member back to a couple of answers that I have already given. We will continue to engage with stakeholders on an on-going basis, and Parliament will set out the committee process.

As I mentioned, at the start of the process, I met Mr Briggs, Mr Griffin and Mr Rennie, and I am happy to meet Dr Gulhane to discuss any issues. The Parliament will set its own parliamentary process for that, including the committee stage.

Sandesh Gulhane (Conservative, Glasgow)

I refer members to my entry in the register of members’ interests: I own a property in Glasgow.

Rents for two-bedroom properties in greater Glasgow have increased by an average of 22.3 per cent from the year before, largely due to the Scottish National Party-Green rent cap.

Patrick Harvie (Green, Glasgow)

Nonsense!

Sandesh Gulhane (Conservative, Glasgow)

Unlike Patrick Harvie, does the minister recognise that impact, or is the SNP still beholden to Green dogma?

Paul McLennan (Scottish National Party, East Lothian)

As I said, I will continue to engage with stakeholders on an on-going basis in that regard and I will take all the evidence that we get from them. The committee stage will be incredibly important for that. We will be speaking to the Local Government, Housing and Planning Committee about homelessness and social justice, and I am happy to engage with the member on that. As I said, at the committee stage, there will be a call for evidence and I imagine that we will get evidence on the particular point that he mentioned. I am happy to meet him to discuss that further.

Bill Kidd (Scottish National Party, Glasgow Anniesland)

Having a fairer well-regulated private rented sector is in the interests of both tenants and responsible landlords. What lessons has the Scottish Government drawn from our European neighbours, where rent controls have been implemented successfully?

Paul McLennan (Scottish National Party, East Lothian)

We have considered a wide range of information on evidence on rent controls, including a bespoke research briefing from the UK Collaborative Centre for Housing Evidence, which included assessment of and references to earlier academic work on rent control systems in both Berlin and Ireland. We also met members of Ireland’s Residential Tenancies Board. We continue to consider the experiences of other countries’ rent control systems and to work closely with a range of stakeholders to understand their perspectives as we deliver a rent control system that is right for Scotland.

Katy (Labour, West Scotland)

Will the minister provide a timetable for when a rent control system will be in operation, given that the system that was recently introduced by the now-departed Minister for Zero Carbon Buildings, Active Travel and Tenants’ Rights introduced a complicated system of transitional measures? Does the minister envisage that those measures will be in operation until there are rent controls?

Paul McLennan (Scottish National Party, East Lothian)

As I mentioned previously in the chamber, I will take the Housing (Scotland) Bill forward, if I am in the same post after today. When the new First Minister is in place and has a chance to discuss it, the matter and the process around it will be reviewed, although part of the process will be determined by the Parliament. I will be happy to come back to the member on that point.

Keith Brown (Scottish National Party, Clackmannanshire and Dunblane)

To ask the Scottish Government what support it is providing to organisations in Clackmannanshire to tackle poverty and inequalities. (S6O-03408)

Paul McLennan (Scottish National Party, East Lothian)

The Scottish Government is supporting a range of work in Clackmannanshire to tackle poverty and inequality. About six months ago, I visited the Clackmannanshire Citizens Advice Bureau in Alloa to discuss the issues in that area. Our work includes collaboration with the local authority; the family wellbeing partnership, which is supporting improved local services and outcomes; the early adopter community project, which funds the local authority to build a system of childcare by developing services and supporting children and their families with childcare costs; and a range of third sector and grass-roots organisations through different funds that are intended to tackle poverty and inequality and improve outcomes for children, families, adult learners and communities.

Keith Brown (Scottish National Party, Clackmannanshire and Dunblane)

I am aware that there will be a ministerial visit to Clackmannanshire shortly to learn more about some of the innovative work that is taking place between the local authority, the third sector and communities in the family wellbeing partnership, which is delivering significant positive outcomes. What more can the Scottish Government do to support such early intervention and prevention initiatives, which help those who are experiencing the greatest disadvantage?

Paul McLennan (Scottish National Party, East Lothian)

As the members says, the Scottish Government is a key partner alongside the local authority and the Clackmannanshire family wellbeing partnership. Officials regularly meet colleagues from the local authority to progress and support the partnership’s aims to tackle poverty and inequality and to improve services. The partnership is, in turn, supporting wide-ranging engagement with local partners and stakeholders. Additionally, senior Scottish Government officials, including the permanent secretary, visited in March to learn about the work in Clackmannanshire, with the Deputy First Minister and the Minister for Children, Young People and Keeping the Promise visiting in August and October 2023 respectively.

Edward Mountain (Conservative, Highlands and Islands)

I remind members of entry in the register of members’ interests, in that I rent out long-term family homes in Moray.

To ask the Scottish Government what analysis it has carried out on any prospective rent rises following the expiry of the rent cap. (S6O-03409)

Paul McLennan (Scottish National Party, East Lothian)

Following expiry of the rent cap, we continue to closely monitor all available evidence on the private rented sector.

The regulations that came into force on 1 April to temporarily modify how rents in relation to most tenancies are determined on referral to rent service Scotland or the First-tier Tribunal for Scotland housing and property chamber—in order to smooth the transition out of the rent cap and to protect tenants from steep rent increases that could have been experienced if there was a sudden move back to open market rent levels—will provide important data to consider on rent increases going forward.

Edward Mountain (Conservative, Highlands and Islands)

That is interesting. The missing point is that, since the removal of the rent cap, on average, rents have increased by 14 per cent. In addition, landlords held back on improving the fabric of their properties while the rent cap was in place. The rent cap has seen bigger than average increases, and climate targets have been threatened. Is the Government as proud as the Greens are of achieving those negatives?

Paul McLennan (Scottish National Party, East Lothian)

There are a number of points there. As I said, we are learning from the process as we come out of it. There are different examples of rent increases in different parts of Scotland, and that is part of the evidence that we need to consider carefully as the bill progresses.

Audrey Nicoll (Scottish National Party, Aberdeen South and North Kincardine)

Will the minister outline how the new regulations that have come into force build on the existing protections that were in place for tenants prior to the emergency rent cap measures, and how they continue to ensure that the Scottish Government provides much greater protection for tenants than the protection that is provided anywhere else in the United Kingdom?

Paul McLennan (Scottish National Party, East Lothian)

Even before the emergency measures, tenants in Scotland were able to refer rent increases to a rent officer, who had the power to vary the rent that was proposed by the landlord. The temporary modifications to rent adjudication mean that a rent officer will not set the rent higher than what a landlord originally proposed and will maybe set rent at a lower value, in line with the tapered approach that is in place to support the transition away from the emergency measures. In England and Wales, the residential property tribunals will not set a disputed rent below the market value and tenants may be required to pay tribunal fees.

Sharon Dowey (Conservative, South Scotland)

To ask the Scottish Government what steps it is taking to tackle homelessness in Ayrshire. (S6O-03410)

Paul McLennan (Scottish National Party, East Lothian)

Local authorities have a legal duty to help people who are homeless or at risk of being homeless. The three Ayrshire local authorities will receive almost £970 million in 2024-25 through the local government settlement, which is used to fund a range of services, including homelessness services. On top of that, the Scottish Government is providing £30.326 million in 2024-25 to the Ayrshire authorities to deliver more affordable homes and £611,000 to support them with the transition to rapid rehousing. The aim of rapid rehousing is to ensure that people have a settled home as quickly as possible.

Sharon Dowey (Conservative, South Scotland)

There is widespread concern about the Scottish Government’s £200 million cut to housing. I recently visited Barnardo’s Scotland’s South Ayrshire services. During the visit, Shine, its women’s mentoring service, highlighted concerns about housing provisions for women, which mean that women may leave prison and custody without knowing where they are to sleep that night. That can lead to barriers to accessing further support, as many social security applications require a home address. What action is the Scottish Government taking to tackle that on-going issue? Is the minister willing to meet me and this group to discuss the issue further?

Paul McLennan (Scottish National Party, East Lothian)

There are a number of issues. I mentioned the homelessness prevention duties that will come on to local authorities, which I think will make a real difference. I am already discussing that with local authorities.

The member will be aware that an additional £80 million over two years was announced for the affordable housing supply programme, which will support the continuation of the previous national acquisition programme, which delivered more than 1,000 affordable homes. At the end of this month, I will meet all local authorities to discuss that acquisition plan. Of course, I will be happy to meet Sharon Dowey and colleagues to discuss the issues that she raised.

Liam Kerr (Conservative, North East Scotland)

To ask the Scottish Government what discussions the Minister for Housing has had with ministerial colleagues regarding the potential impact of the new build heat standard on the completion of new homes. (S6O-03411)

Paul McLennan (Scottish National Party, East Lothian)

I regularly meet ministerial colleagues to discuss various associated portfolio interests, including the heat in buildings policy. The standard was scrutinised by the Local Government, Housing and Planning Committee and approved without opposition. It is an essential part of our commitment to reach net zero and will have a positive impact on new housing. It was subject to full consultation in 2021 and in 2022, with both consultations showing strong support.

Obviously, we have heard the concerns that have been raised about the new build heat standard in rural and island communities and are taking those on board fully.

Liam Kerr (Conservative, North East Scotland)

Since 1 April, the new build heat standard has banned direct emission heating systems, including those using bioenergy sources, such as wood-burning stoves. The consultation draft of the Scottish Government’s bioenergy policy statement says:

“as a renewable, and potentially net zero, energy source bioenergy may represent the best option to help decarbonise some homes”.

Will the minister listen to his Government colleagues and review the ban on wood-burning stoves in Scotland’s homes, or are the Government’s strings still being pulled by his former Green Party colleagues?

Paul McLennan (Scottish National Party, East Lothian)

As I mentioned, we have heard the concerns about the reliance on wood-burning stoves in rural areas and are taking them fully on board. Just last week, I visited Eigg and discussed a number of issues up there. That issue was raised, and I said that I would come back to the people there on that particular point. Of course, the Scottish Government recognises that emergency use of heating, including wood-burning stoves, will sometimes be required. However, as I said, we will continue to engage fully with stakeholders and others in that regard. Again, I am happy to engage with Mr Kerr on that point.

Annabelle Ewing (Scottish National Party, Cowdenbeath)

That concludes portfolio questions on social justice. 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 so wish.

World Asthma Day 2024

Annabelle Ewing (Scottish National Party, Cowdenbeath)

The final item of business is a members’ business debate on motion S6M-12707, in the name of Emma Harper, on world asthma day 2024. The debate will be concluded without any question being put.

Motion debated,

That the Parliament notes World Asthma Day 2024, which will take place on 7 May 2024; recognises that the Global Initiative for Asthma, supported by the World Health Organization, will this year mark the theme of “Asthma Education Empowers”; understands that around 360,000 people, including 72,000 children, have an asthma diagnosis in Scotland; further understands that asthma is one of the most common chronic non-communicable diseases that affects over 260 million people globally, and is responsible for over 450,000 deaths each year worldwide, most of which are preventable, and that, according to the Global Initiative for Asthma, one of the key universal issues for which education is required is the under-diagnosis or inaccurate diagnosis, including of people with severe asthma, underuse of anti-inflammatory inhaled corticosteroid inhalers, overuse and over-reliance on short-acting beta2-agonist (SABA) inhalers, and poor recognition of patients requiring specialist assessment and further asthma care management; notes the reported difference in severe asthma compared with unstable asthma, and understands that poorly controlled severe asthma can take a toll on health and wellbeing; welcomes the Scottish Government’s Respiratory Care Action Plan, which aims to improve prevention, diagnosis, treatment, care and self-management of asthma and lung conditions; notes the calls on the Scottish Government to provide an update on the effectiveness of the plan in helping to improve outcomes for people living with asthma; welcomes the work of Asthma + Lung UK Scotland to improve asthma care in Scotland and to support people who receive an asthma diagnosis and their families; further welcomes the creation of the International Coalition of Respiratory Nurses (ICRN) in 2023, which brings together nurses and allied health professionals from across the globe to advance the care and treatment of patients with respiratory conditions, including asthma, and notes the view that better asthma care at all levels of healthcare can lead to better outcomes and lives for people living with asthma.

Emma Harper (Scottish National Party, South Scotland)

I welcome the opportunity to lead this important debate to recognise world asthma day 2024, which took place yesterday, 7 May, with the theme “Asthma Education Empowers”. I thank members who have supported my motion, allowing the debate to go ahead today. I also thank Asthma and Lung UK Scotland for its briefing and for all that it does in respect of research, advice and support for persons with an asthma diagnosis and their families.

Gareth Brown from Asthma and Lung UK Scotland serves as the secretariat for the cross-party group on lung health, which I co-convene with my colleague Alexander Stewart. Gareth does a great job, and I thank him for all his work. The CPG has done work relating to asthma previously, and the input from clinicians, asthma support groups and those who are living with asthma is welcome. My thanks go to the Minister for Public Health and Women’s Health for her active engagement with our cross-party group. One of our CPG members, Olivia Fulton, chairs a group that focuses on severe asthma, which meets online—I will say a wee bit more about Olivia later in my speech.

As my motion indicates, world asthma day is organised by the Global Initiative for Asthma, which is a World Health Organization collaborative that was founded in 1993. There is a lot of great info on the GINA website, which I encourage people to visit to find out more.

Asthma is a very common long-term lung health condition. In the United Kingdom, 5.4 million people have an asthma diagnosis—that is one in every 12 adults and one in every 11 children. In Scotland, 368,000 adults and about 71,000 children live with an asthma diagnosis. People with asthma might have sensitive, inflamed and irritated airways. Asthma symptoms can come and go; sometimes people might not have symptoms for weeks or months at a time. However, asthma needs to be treated every day, even if someone feels well, in order to lower the risks of their symptoms being exacerbated and of having an asthma attack.

The most common symptoms of asthma are coughing, wheezing—which is a whistling sound when you breathe—breathlessness and chest tightness. Experiencing one or more of those symptoms could mean that you have asthma. It is more likely to be asthma if your symptoms keep coming back, if they are worse at night or if they occur when you react to a trigger such as exercise, weather or an allergy such as pet hair or pollen. Anyone who experiences those symptoms should speak to their general practitioner as soon as possible.

The seriousness of asthma varies from person to person. There are different types of asthma—indeed, there is an important difference between severe asthma and uncontrolled asthma. Uncontrolled asthma improves with treatment changes such as steroid inhalers and good inhaler technique, but someone with severe asthma, which affects about 5 per cent of people with asthma, can have symptoms most of the time and can find them very hard to control.

Poorly controlled severe asthma takes a toll on people’s physical and mental health, leading to an average of four asthma attacks per year. Among people who live with severe asthma, 55 per cent report depression, 66 per cent report anxiety and 68 per cent say that it impacts their work and education. Where people live also has a bearing on outcomes, as those in the poorest areas of Scotland are, on average, three times as likely to be admitted to hospital as a result of their asthma.

There is a huge financial cost. In Scotland, the cost of treating respiratory disease is estimated to be £500 million each year, and asthma care represents £97.5 million of that spend. Flare-ups of severe asthma can result in patients presenting in the costliest part of the healthcare system: accident and emergency departments. Data suggest that people with severe asthma attend A and E departments roughly four times more often than people with non-severe asthma.

However, the situation can improve. Earlier, I mentioned Olivia Fulton, who is a great example of how improvement in severe asthma care can be achieved. She had serious challenges with her severe asthma, but thanks to proper care and treatment, she is now playing for Scotland’s women’s wheelchair rugby team. Asthma education has certainly empowered Olivia.

Since 2013, Asthma and Lung UK Scotland has surveyed people with asthma, and, earlier this year, it launched its “Life with a Lung Condition” survey for the second time. The survey results highlighted that 24 per cent of Scots received all three recommended aspects of asthma care: an annual review of their asthma care and treatment, a check-up on their inhaler technique and a written asthma action plan. In particular, 75 per cent of those who were surveyed said that they received an annual review, 50 per cent said that their inhaler technique was checked and 40 per cent said that they had received a written asthma plan.

I would welcome an update from the minister regarding what further steps the Scottish Government could take to increase awareness of asthma education in Scotland so that people know what their entitlements are and are empowered to press for them.

In 2021, the Scottish Government launched the “Respiratory Care Action Plan 2021-2026”, which sets out a vision for driving improvement in prevention and in the diagnosis, care, treatment and support of people living with respiratory conditions in Scotland. One aspect of the plan is that the pillars of asthma care should be available to everyone, so I would welcome an update from the minister on the implementation of the RCAP.

I will touch briefly on the link between asthma and inequality. We know that people from the most deprived areas of Scotland are much more likely to receive an asthma diagnosis. Managing a variable lifelong condition with complex treatments such as inhalers is difficult; managing asthma while juggling multiple jobs, family responsibilities and financial pressures is even harder.

I welcome the Scottish Government’s commitment to tackling health inequalities, and it is important to note that good-quality housing, sound state welfare support and good air quality are key components of achieving health equality. With regard to air quality, 57 per cent of those who are living with asthma in Scotland say that air quality makes them feel more breathless.

In closing, I highlight one final point: the importance of working across countries to learn from experience and ensure good practice. The International Coalition for Respiratory Nursing—of which I am a member, as I am still a registered nurse—was created in 2021. The ICRN is a global network of advanced respiratory nurse practitioners, with the aim of working together to improve care for people who live with lung conditions and to educate and empower patients. I support this year’s world asthma day theme, “Asthma Education Empowers”, as educating people empowers them to receive improved care and, consequently, have healthier outcomes.

Again, I welcome the debate, and I look forward to contributions from colleagues.

Jackie Dunbar (Scottish National Party, Aberdeen Donside)

I congratulate Emma Harper on securing this members’ business debate for world asthma day. Asthma is a chronic respiratory disease that affects more than 250 million folk around the world. In Scotland, about 360,000 folk are diagnosed as suffering from asthma, including more than 72,000 children, and there will be many more folk out there without a diagnosis at this point.

I do not think that many colleagues will be surprised to hear that I am one of those 250 million—especially colleagues who noticed me catching my breath when I was trying to ask a general question in the chamber a few weeks ago. It is no always easy to be wheezy.

I remember when I first went to the doctor and was diagnosed as borderline asthmatic or as having borderline chronic obstructive pulmonary disease—I remember that the doctor was unable to tell me which condition it was. I was given three different inhalers: one for asthma symptoms, one for COPD symptoms and a blue inhaler for if and when I needed it. It is a pity that I had not carried it with me on the day that I needed it in the chamber.

There was a fair bit of trial and error to find what worked for me, and I know that I am not alone in that experience. What works best for me is not just inhalers—what I no longer puff has made a real difference. I quit smoking more than four years ago, after being a smoker for nearly four decades of my life, and I feel that that has made a huge difference to my health. Although I am trying to be healthier and I have my inhalers, living with asthma can still be challenging. However, the more I learn about asthma, the easier it gets. Education can empower folk to manage their conditions and to go about their lives as they wish.

There are a few things that it is helpful to know. Those include what asthma is and what is happening to your lungs; what your symptoms are; how to manage your symptoms; how to recognise whether your symptoms are getting worse; and what can be a trigger for your asthma—for example, pets, perfume or deodorant—and how to avoid those triggers. However, that is not an invitation for anyone to stop wearing deodorant; as with many other things in the Parliament, there is a balance to be struck.

Finally, the most important thing that I feel folk should know, whether or not they are asthmatic, is how to recognise an asthma attack and what to do about it. The main symptoms of an asthma attack are if your asthma symptoms—coughing, breathlessness, wheezing or a tight chest—are getting worse; if your inhaler is not working; if you are too breathless to speak, eat or sleep; if your breathing is getting faster and it feels like you cannot catch your breath; or if your peak flow score is lower than normal. Children might also complain of a tummy or chest ache.

Once you have recognised an asthma attack, here is what to do. First, sit up straight and try to keep calm—I realise that that is easier said than done. Take a puff on your inhaler—usually your blue one—every 30 to 60 seconds, for up to 10 puffs. If you feel worse at any point or if you do not feel any better after 10 puffs, dial 999 for an ambulance immediately.

I conclude my remarks with that life-saving advice and congratulate my friend Emma Harper again on securing this important debate.

Alexander Stewart (Conservative, Mid Scotland and Fife)

I am delighted to make a contribution to this debate, and I thank Emma Harper, who is a fellow member and co-convener of the cross-party group on lung health, for securing it.

Back in February this year, I lodged a parliamentary motion on people with uncontrolled asthma to highlight the issue of severe asthma. Thereafter in February, I was very pleased to sponsor an exhibition in the members lobby entitled “Better lives for people with uncontrolled asthma”, which was specifically for MSPs and staff to find out more about severe asthma. That is a serious public health challenge in Scotland, and it is classified as a disability under the Equality Act 2010.

The adverse implications of severe asthma can put a significant strain on our healthcare system. We already know that asthma, which affects about 17 per cent of adults, is the most common respiratory disease in Scotland. However, severe asthma affects more than 4 per cent of that population, and it is sometimes quite difficult to manage. In the cross-party group, we have learned about all the things that can support people with that.

Asthma and Lung UK has estimated that Scotland has among the highest prevalences of severe asthma in the United Kingdom. Poorly controlled severe asthma challenges people’s mental and physical abilities. We know that the condition leads to an average of four asthma attacks a year. Well over half of people who live with it have depression or anxiety, which leads them on to other problems with their health and wellbeing. About 70 per cent of patients report that the condition severely impacts their work or education.

A key opportunity to improve outcomes for patients with severe asthma is through improving the pathway towards accurate diagnosis. We have talked in the past about diagnosis and delays in referrals to specialist clinics to undertake patient-centred assessments. We need to deal with that.

I welcome the fact that the theme of this year’s world asthma day is “Asthma Education Empowers”. That tells us a lot about what we can do when we talk about accurate diagnosis and how people can be treated. For some patients, that might mean starting on a medicine class known as biologics. Those medicines transform lives, but only one in five people receives such therapies in Scotland. We need to consider how more people can be accessed, because access to treatment will save lives.

Emma Harper (Scottish National Party, South Scotland)

In the cross-party group, we have talked about how pulmonary rehab and singing help with chronic obstructive pulmonary disease. Does Alexander Stewart agree that PR and singing can help folk with asthma, too?

Alexander Stewart (Conservative, Mid Scotland and Fife)

Without question. There is the whole idea of working the lungs. I do not have asthma but, as Emma Harper knows, I do a little bit of singing, and I know how that helps me.

Annabelle Ewing (Scottish National Party, Cowdenbeath)

Is Mr Stewart about to burst into song?

Alexander Stewart (Conservative, Mid Scotland and Fife)

I will not sing this evening. Members can come to the choir to hear me some other time.

As I said, we must ensure that we have access to experts and clinicians across Scotland and that the issue of access is looked at. I look forward to hearing what the minister has to say on that, because we know that there needs to be much more equal access to advanced therapies, which can be transformative. We must manage severe asthma.

I hope that the minister will, in her summing up, talk about: where we are when it comes to the progress of the respiratory care action plan; a pledge to address the misdiagnoses and the underdiagnosis that we know are taking place; implementing clear national once-for-Scotland protocols, because we know about the issues of disparity; establishing nationally agreed severe asthma referral pathways that promote collaboration between primary and specialised care; and collaboration across partners, including patient advocacy groups, as well as the third sector.

Jackie Baillie (Labour, Dumbarton)

I thank Emma Harper for securing this debate to mark world asthma day 2024. I also say well done to Jackie Dunbar, and urge her to keep going. I gave up smoking 22 years ago and have never looked back, so I encourage her to keep at it.

As Emma Harper and Alexander Stewart have said, this year’s theme is “Asthma Education Empowers”. That is important, because knowledge of how to access good and timely treatment can be life changing for those living with asthma.

Asthma and Lung UK’s 2024 survey revealed that basic asthma care levels continue to fall in Scotland, with only 24 per cent of sufferers receiving the three basic provisions of asthma care. Data also shows that, in Scotland, there are significantly low levels of uptake of specialist treatments such as biologics for those who might be eligible. There is a postcode lottery across Scotland. It is interesting to note that, despite its own challenges, NHS England currently leads Scotland with a 17 to 21 per cent higher uptake. There is something that we can learn from that.

Clearly, there are issues with the levels of education about and knowledge of what services are available in Scotland, in both specialist treatments and basic asthma care. However, the problem lies not with public knowledge alone; Asthma and Lung UK has reported concerns that the Scottish Government does not accurately collect and report the correct number of people living with respiratory conditions, which is an issue that anyone with an interest in long Covid will be familiar with. That matters, because poor data collection means poorer treatment options and, ultimately, poorer patient outcomes. The issue must be addressed.

Patients have also raised concerns about a lack of awareness in primary care, leading to delays in specialist referrals to clinics for patient-centred assessment and to gain an accurate diagnosis. The more that we ensure that GPs are properly supported and have the time to take opportunities to expand their knowledge of and education on subjects such as asthma, the more that we can ensure that patients are signposted and treated before their symptoms worsen or they end up in hospital.

The survey further showed that only 40 per cent of people hospitalised with asthma were getting the follow-up care that they needed within two days of leaving hospital. That is the case, despite current Scottish Intercollegiate Guidelines Network guidance stating that follow-up care is required to ensure that symptoms remain under control. The result is that around one in six people who receives emergency care for an asthma attack needs hospital care again within two weeks. There is, therefore, a logic to our getting prevention right. We know that the national health service is already under immense pressure, and the lack of that basic follow-up care only exacerbates the problem.

Patients and health professionals need support from the Scottish Government if asthma education is to actually empower them. They need better data collection, action in primary care to improve diagnostic tools and public health campaigns that provide up-to-date information about treatment. Scotland also needs the timely implementation of the respiratory care action plan’s severe asthma recommendations, the creation of clear, national, once-for-Scotland protocols for severe asthma and the establishment of nationally agreed severe asthma referral pathways, which will promote collaboration between primary and specialised care.

Without action to address those issues, asthma will continue to be a significant public health challenge in Scotland, causing pain and discomfort and placing strain on the NHS that is avoidable.

Carol Mochan (Labour, South Scotland)

I thank Emma Harper for bringing this important debate to the chamber. I recognise the knowledge and skills that she has in this area and I praise the on-going work that she is committed to doing in the Parliament and beyond. I have heard her speak about this subject many times, and it is much appreciated.

Scottish Labour welcomes, as my colleague Jackie Baillie does, world asthma day 2024, which is supported by the World Health Organization and took place yesterday. We recognise this year’s theme of “Asthma Education Empowers”.

As far as prevalence is concerned, asthma in Scotland affects, as we have heard, around 368,000, 71,000 of whom are children. An important point that has been raised by Asthma and Lung UK as well as by members relates to the collection and recording of information. Currently we do not have an accurate collection method or an agreed reporting system across health boards and the Scottish Government, and given that, according to the Royal College of Physicians report, two thirds of asthma-related deaths could be preventable, I ask the minister whether the Scottish Government is looking at that issue. Perhaps she will say something about that in her closing remarks.

As other members have said, medical advisers and professionals who work in the field have identified key risk factors in managing the condition, including the overuse of relief inhalers, the underuse of preventer inhalers and recent emergency hospital visits with no follow-up. Such factors give great insight into the reasons for this year’s theme of education empowering people; it makes it clear that it is important to teach people with asthma about their condition and that, by learning about it, they can manage their symptoms better. That helps the patient, the doctors and the NHS.

When I did some research for the debate, it became clear that we need strong will and a strong commitment from the Government to prioritise this lifelong condition. According to recent Asthma and Lung UK research, many Scots with asthma are falling short on the basic care guidelines. We know that there is pressure on NHS staff, so I ask the minister to tell us how she believes that the Government can help to reverse that pressure on staff and offer asthma sufferers some hope that the outcomes from that condition can be changed.

We have heard about three things: an annual review, an inhaler technique check and a written action plan. The research shows that only 24 per cent of Scots received all three; 25 per cent received one; and 17 per cent reported receiving none. This is an important matter, and I know that the minister will consider it to be so. We would, I think, all agree that every person with an asthma diagnosis should be offered all three elements; they should know that that is their basic treatment plan and entitlement.

In my final minute, I ask the minister, as others have done, to update us on the care action plan and to point to some specific points of action that the Government has undertaken, so that people with asthma can feel that moves are being made and improvements for their care are being put in place.

Again, I thank Emma Harper for securing the debate and all the members who have contributed to it.

Jenni Minto (Scottish National Party, Argyll and Bute)

I, too, thank Emma Harper for lodging this important motion, and I welcome the opportunity to respond on behalf of the Scottish Government. I also put on record my thanks to those who support people living with asthma in Scotland, including our NHS and third sector organisations such as Asthma and Lung UK. Finally, I thank Emma Harper and Alexander Stewart for their sterling work in the CPG. I have interacted with them before and will be happy to do so again, if I am still in this role.

Carol Mochan is absolutely right to say that asthma is important to me. Both my father and brother had it, and, going back to what Jackie Dunbar said, I remember that, any time we went out, we had to make sure that the appropriate inhalers were packed. I also thank Emma Harper for outlining the symptoms.

World asthma day gives us time to reflect on the progress that has been made in respiratory care and on the challenges that we face. We know that care and treatment for conditions such as asthma are not always where they need to be, but we are continuing to work collaboratively across our whole system to tackle it.

The Scottish Government is committed to improving services across the country and meeting needs through the implementation of a respiratory care action plan. The plan sets out key priority areas for driving improvement in prevention, diagnosis, care, treatment and support for people living with a range of respiratory conditions.

As well as the national plan, significant work is being done across the wider health and social care landscape. The centre for sustainable delivery supports professionals across Scotland to come together and share best practice while working towards consistent once-for-Scotland pathways in respiratory services, A priority in the current work plan of the respiratory specialty delivery group is the development of a once-for-Scotland asthma pathway. Indeed, the group’s aim is to design a national pathway in partnership with clinicians and, importantly, those who live with asthma.

A major milestone in asthma care this year has been the publication of “Quality Prescribing Strategy for Respiratory: A Guide for Improvement 2024-2027”. The document aims to keep people at the centre of their treatment and respiratory disease management and to promote safe, evidence-based and sustainable prescribing with regular reviews of medication. The guide will support clinicians across the multidisciplinary team and people with respiratory conditions in shared decision making, and it offers practical advice and options for tailoring care to individuals’ needs and preferences.

Alongside the guide, a suite of national therapeutic indicators that has been developed with Public Health Scotland will allow clinicians to identify those most in need of a review. Primary care teams will be able to drill down to cluster and practice-level data and benchmark across Scotland, driving consistency in care.

It is important to address the point that Jackie Baillie and Carol Mochan made about the importance of data. We are currently working with Asthma and Lung UK and other key partners on commissioning a full national audit programme for respiratory conditions.

The prescribing guide also has a focus on net zero. Many people with asthma might be surprised to learn that the environmental impact of inhalers for treating asthma and COPD is equivalent to around 80,000 tonnes of CO 2 a year. That is more than the emissions from the entire NHS fleet and full NHS waste combined. We want to ensure that patients and their prescribing clinicians are equipped with the facts to enable them to make choices.

We also understand that environmental factors play a huge role in the day-to-day lives of people who live with lung conditions such as asthma. Our vision for Scotland is to have the cleanest air in Europe, and we are committed to protecting the public from the effects of poor-quality air as quickly as possible. The introduction of low-emission zones in our four largest cities in 2022 was a key initiative in further improving urban air quality.

I congratulate Jackie Baillie and Jackie Dunbar on their smoking cessation. I was just commenting to a friend that I can remember getting the no-smoking lesson back in primary school; one of my friends went back to his parents’ house, where his father smoked, and he stuck stickers all the way up the stairway. They got ripped off, but the marks were still there. The father has now stopped smoking, which is great. It took a long time, but he did it.

As a Government, we remain committed to a tobacco-free Scotland by 2034, and the United Kingdom Tobacco and Vapes Bill will help us to achieve our ambitious target. Scotland has a range of world-leading tobacco-control measures, and smoking rates continue to decline. Our tobacco and vaping framework, which was launched on 22 November last year, sets out our road map to 2034 and outlines decisive action, including work on the Tobacco and Vapes Bill, to ensure that we hit our goal. That suite of preventative measures will help people better manage their condition and support us in preventing respiratory disease in future generations.

I agree with everyone who has talked about the appropriateness of the theme of this year’s world asthma day: “Asthma Education Empowers”. As Carol Mochan has said, we understand the benefits of empowering people with asthma through the appropriate education, so that they can manage their disease and recognise when to seek medical help.

We also work with many third sector partners who provide invaluable support to those living with lung disease. I am not going to start singing now, but I spent an amazing couple of hours singing for lung health with the Cheyne Gang in Leith, which Emma Harper introduced me to. I know that the chamber would not want me to sing, but it was great.

Annabelle Ewing (Scottish National Party, Cowdenbeath)

The fact that you were singing will be clear for the Official Report , minister, so please do not start.

Jenni Minto (Scottish National Party, Argyll and Bute)

I will not, but it was amazing—I thought that you were about to tell me that my seven minutes was up, Presiding Officer. In any case, the event was clearly about encouraging people to think about breathing with their entire lungs and giving each other peer support.

In 2023-24, more than 600 nurses accessed training modules as part of our respiratory care action plan to build on the knowledge and skills in the NHS workforce. Another positive development has been the delivery of guidance for children living with asthma transitioning into adult services. We know that that is a particularly challenging time for young people, their families and carers, and that not all areas of Scotland offer transition services, but guidance has been developed by a group of asthma specialists in partnership with the third sector and those with first-hand experience of a good transition.

I will close by reiterating the Government’s commitment to ensuring that everyone living with asthma in Scotland receives the best possible care and support. As we move through 2024, we know that there is still a way to go in respiratory care and the only way that we will improve is by understanding the needs of those who live with the condition. My thanks go to all members who have contributed to this important debate today, and, most important, to those working across health and social care to deliver those commitments.

Annabelle Ewing (Scottish National Party, Cowdenbeath)

That concludes the debate.

Parliamentary Bureau Motions

Alison Johnstone (Presiding Officer, Lothian)

The next item of business is consideration of two Parliamentary Bureau motions. I ask George Adam, on behalf of the Parliamentary Bureau, to move motions S6M-13123, on approval of a Scottish statutory instrument, and S6M-13124, on committee meeting times.

Motions moved,

That the Parliament agrees that the Registration of Social Workers and Social Service Workers in Care Services (Scotland) Amendment Regulations 2024 [draft] be approved.

That the Parliament agrees that, under Rule 12.3.3B of Standing Orders, the Standards, Procedures and Public Appointments Committee can meet, if necessary, at the same time as a meeting of the Parliament following the Appointment of Scottish Ministers on Thursday 9 May 2024.—[George Adam]

Alison Johnstone (Presiding Officer, Lothian)

The questions on those motions will be put at decision time.

Gender Identity Services for Children and Young People (Cass Review)

Annabelle Ewing (Scottish National Party, Cowdenbeath)

The next item of business is a debate on motion S6M-13090, in the name of Meghan Gallacher, on implementing the Cass review in Scotland.

Meghan Gallacher (Conservative, Central Scotland)

Yesterday, I attended the Health, Social Care and Sport Committee’s meeting to hear directly from Dr Hilary Cass following her review of gender care services for children and young people. I had hoped to ask a question but, despite emailing the committee on Friday, I was told that time had run out. Unfortunately, that was just the latest in a series of questions that I have raised on the topic that have been rejected or denied. The fact of the matter is that children, young people, parents and campaign groups deserve answers, which is why my party has brought a debate on the issue to the Parliament.

Talking about gender in Scotland has become toxic, but we need to be clear that the Cass review is not about ideology. It is a scientific evidence-based review of the medical care that we have been giving to vulnerable young children. It is a monumental and fearless piece of work. I say “fearless” because, even amid the toxicity of the gender debate, the crucial report did not shy away from its difficult findings—namely, that we have been letting down a generation of vulnerable and distressed children.

One would think that the publication of a damning report on the medical care of children would jump straight to the top of any Government’s in-tray and that politicians of all stripes would be united in wanting to ensure that mistakes and poor practices were stopped immediately and that the required improvements were put in place. However, the response from the Scottish National Party Government could not have been more lacklustre.

From the moment that the Cass review was commissioned four years ago, the SNP Government sought to dismiss it as being irrelevant to Scotland, even though the medical approaches that were being reviewed were almost identical to those that were being used here. The Government disregarded the interim report, which cast doubt on the safety of puberty blockers for children, and, when the final report was published last month, it dithered, delayed and obfuscated until clinicians took the decision out of its hands by announcing that NHS Scotland would pause the use of puberty blockers for under-18s.

Although the use of puberty blockers is undoubtedly one of the key aspects of the Cass review, the nearly 400-page document makes a total of 32 recommendations to improve gender care for young people in Scotland. The recommendations include offering children fertility counselling before they proceed down a medical pathway; assigning a child a medical practitioner to take charge of their care and ensure that they get the personalised help that they need; support for parents, carers or siblings if needed; and a requirement to keep a national data set on gender services in order to continually update best practices.

The SNP has continued to be deafeningly silent on those and a host of other reasonable, commonsense recommendations. I made a promise to families who have been failed by gender care services in Scotland, and I intend to keep raising the issue until the Scottish Government implements all 32 recommendations of the Cass review without delay.

The Cass report should fundamentally change how we look at gender care in Scotland. It should be approached with caution and care, and it should be given holistically, viewing a child as a rounded individual and tailoring the approach to their unique needs. Yes, the report concludes that there is little evidence to support use of puberty-suppressing hormones, but it also details that children and young people might not be offered the right psychological support and assessments when experiencing gender distress. Medical intervention is not always required, but that has been common practice for many individuals. Meanwhile, children’s mental health has been left to deteriorate.

Although the Sandyford clinic has finally paused its use of puberty blockers and cross-sex hormones for those who are under the age of 18, gender care services need a complete overhaul. The Scottish Government needs to make that a priority because, as things stand, the waiting times for children and young people to see a clinician at a gender clinic can be over four years. Child and adolescent mental health services waiting times are through the roof, and the SNP has remodelled the funding of gender care services, which has resulted in a cut to the budget of those services.

I say to members, regardless of their opinion on the Cass review or on gender care services, that the Scottish Government is failing young people.

Rachael Hamilton (Conservative, Ettrick, Roxburgh and Berwickshire)

Does Meghan Gallacher believe that there is no excuse for the SNP not to implement the recommendations of the Cass review now that it has broken up its tragic coalition with the Greens?

Meghan Gallacher (Conservative, Central Scotland)

Absolutely. This is an opportunity to reset, refocus and actually prioritise young people who need the Government’s support.

The Cass review is a four-year-long, near-400-page report on the care that we give to some of our country’s most vulnerable children. The fact that we have been failing them for so long is bad enough, and we should all reflect on that. However, to ignore the scientific evidence-based report for the sake of dogma and ideology would be unforgivable. This is about the health, safety and wellbeing of our young people. There are no other national health service services that we would allow to continue unchanged after such a report had been brought forward and had shown that they were failing, and this service should be no different.

Next week, I will hold an event in Parliament with Marion Scott from the Sunday Post . That will be an opportunity for MSPs, ministers and cabinet secretaries to speak with families who are affected by gender care and to hear how they have been failed by the processes that are in place in Scotland. I urge all MSPs, regardless of their persuasion or political party, to speak to the families who have bravely stepped forward to tell their stories.

It is clear that we need to implement all 32 recommendations of the Cass review, as our motion says. That is simple, but it will show that we in this Parliament care about young people who are experiencing gender distress. The message that I have for MSPs is that, if they do not back our motion today to implement the full recommendations of the Cass review, they will need to explain to the families why they have not done so, because those families are the ones who have been impacted by the Scottish Government’s lack of decision making and action.

Annabelle Ewing (Scottish National Party, Cowdenbeath)

Ms Gallacher, I ask you to move the motion, please.

Meghan Gallacher (Conservative, Central Scotland)

I move,

That the Parliament welcomes the report submitted by Dr Hilary Cass on gender identity services for children and young people; recognises the report as a valid scientific document, and calls on the Scottish Government to implement the recommendations of the report that are applicable to NHS services in Scotland.

Jenni Minto (Scottish National Party, Argyll and Bute)

Just over two weeks ago, I stood in the chamber to emphasise what is undeniably a fact: that young people who are questioning their gender or accessing gender identity healthcare, and their families and those who love them, must be at the centre of all our discussions about the delivery of that care. I hope that we will all keep them in our hearts and minds during the rest of the debate and, in doing so, remain compassionate, understanding and respectful.

As I said in my statement,

“it is vitally important that the recommendations”

in the Cass review’s final report, which was published in April,

“are carefully considered”.—[Official Report, 23 April 2024; c 14.]

The Scottish Government has consistently welcomed the report’s publication. The review itself was chaired by a past president of the United Kingdom’s Royal College of Paediatrics and Child Health—a senior and well-respected clinician. Many of us will have heard her helpful and clear evidence at the Health, Social Care and Sport Committee meeting yesterday, and I recognise the Cass review’s final report as a scientific, evidence-based document.

When Dr Cass was asked yesterday for her key conclusions from the review, she said two things: first, that the evidence base in this specialist field of medicine is weak, and we need to work as collaboratively and broadly as we can to improve that evidence base, and secondly, that children and young people need a broad multidisciplinary approach to their care. I think that all of us in the chamber would agree with those two points.

The Scottish Government has already provided grant funding to the University of Glasgow to carry out research into the long-term health outcomes of people who access gender identity healthcare. That will play a part in improving the evidence base. Person-centred and holistic multidisciplinary care has been at the heart of our chief medical officer’s realistic medicine approach for many years, and our clinicians know how important it is to see the whole person whom they care for.

The final report is detailed and wide ranging. It is important that its recommendations are carefully considered in the context of how services are delivered in NHS Scotland, and to consider what further steps may need to be taken.

Rachael Hamilton (Conservative, Ettrick, Roxburgh and Berwickshire)

Will the minister take an intervention?

Jenni Minto (Scottish National Party, Argyll and Bute)

I am going to make progress.

As I made clear in my statement, a senior multidisciplinary clinical team within the chief medical officer’s directorate in the Scottish Government, which includes paediatric, pharmacy and scientific expertise, is carrying out that careful consideration. As Parliament would expect, that work is already under way. The chief medical officer will provide a written update to Parliament on the outcome of that clinical consideration process before the summer recess.

I will take Rachael Hamilton’s intervention now.

Rachael Hamilton (Conservative, Ettrick, Roxburgh and Berwickshire)

Thank you, minister.

In her statement, the minister said that discussions between clinical stakeholders on what further involvement may be appropriate were on-going, and that the chief scientist office was involved. How long will that take? Can the minister put a timeline on those discussions, please?

Jenni Minto (Scottish National Party, Argyll and Bute)

The chief medical officer will provide a written update to Parliament on the outcome of that clinical consideration process before the summer recess. I am sure that colleagues across the chamber will welcome that assessment and will understand, just as NHS England has stated, that, given the comprehensiveness of the report, that will take some time.

Ash Denham (Alba, Edinburgh Eastern)

The minister has just set out that the CMO will seek to provide a written statement to the Parliament on the progress that is being made, but I ask the Government to consider that it might be advisable for the CMO to appear in Parliament to aid that scrutiny.

Jenni Minto (Scottish National Party, Argyll and Bute)

Currently, the CMO is going to provide a written statement, and that is the way that I think the update should be delivered to Parliament.

I know that colleagues across the chamber would not want a knee-jerk reaction to a 400-page report that did not properly consider how services in Scotland are delivered or what work on training or on standards is already under way.