Scottish Parliament, 10 February 2011

382 contributions from 75 members. The official report.

Scotland’s Commissioner for Children and Young People

Alasdair Morgan (Scottish National Party, South of Scotland)

Good morning. The first item of business is consideration of three Scottish Parliamentary Corporate Body motions, S3M-7904 to S3M-7906 inclusive, in the name of Mike Pringle, on the reappointment of the Scottish Public Services Ombudsman, the Scottish Parliamentary Standards Commissioner and Scotland’s Commissioner for Children and Young People.

Mike Pringle (Liberal Democrat, Edinburgh South)

I speak in support of the SPCB’s three motions, which nominate office holders for reappointment. In advance of this short debate, the SPCB lodged a report in the Scottish Parliament information centre—it is also available on the Parliament’s website—regarding the reappointment of each office holder. Although the office holders’ terms in office do not end until April and May this year, we are bringing forward the motions now for the obvious reason that the Parliament will shortly be dissolved.

I turn to the reappointment process. Each office holder has been subject to independent evaluation based on a number of set criteria, including fulfilling the functions of the post, communication, leadership and motivational skills. That was followed by a formal interview with the SPCB.

It is the unanimous view of the SPCB that Jim Martin is the right person for the role of Scottish Public Services Ombudsman. We consider that he has brought about visible and sustained improvements to the case load management of the office. His regular commentaries demonstrate recommendations for public authorities to make improvements to their processes where that is appropriate. He has also introduced a quality assurance process that we believe will continue to drive up the standards that he wants.

Of course, the SPCB is aware that some members have not always agreed with the ombudsman’s decisions, and we received some unsolicited representations about the reappointment of Jim Martin. The Parliament has given the ombudsman the independence to make decisions, and in doing so he is not under our direction or control at all. As with ombudsmen around the world, not all parties will be satisfied all the time. That is simply not possible, given the nature of the job. However, we believe that Mr Martin is the right person and that during his next six-year term in office he will continue to build on the considerable improvements that he has already made in his office.

We are also seeking the Parliament’s support for the reappointment of Tam Baillie as the Commissioner for Children and Young People in Scotland for a period of six years. Many members will be aware of Mr Baillie, given the number of appearances that he has made before a variety of parliamentary committees.

Mr Baillie has taken a different approach to his role from his predecessor, placing a greater emphasis on personal engagement with children and young people. We are aware from a small number of representations that not everybody agrees with the commissioner’s approach. Nevertheless, we believe that it is the role of the commissioner to direct his organisation in the way that he sees fit, provided that it is for the benefit of children and young people in Scotland, and we are nominating Tam Baillie to continue the work that he has started and very much wants to continue.

Finally, it is the SPCB’s role to appoint a Scottish Parliamentary Standards Commissioner, but any appointment has to be endorsed by the Parliament. We are therefore seeking the Parliament’s agreement to the reappointment of Stuart Allan for a second term.

I move,

That the Parliament nominates Jim Martin to Her Majesty The Queen for reappointment for a second term as the Scottish Public Services Ombudsman from 1 May 2011.

That the Parliament agrees with the recommendation of the Scottish Parliamentary Corporate Body under Rule 3A.1.2 of Standing Orders that Stuart Allan be reappointed for a second term as the Scottish Parliamentary Standards Commissioner from 31 March 2011.

That the Parliament nominates Tam Baillie to Her Majesty The Queen for re-appointment for a second term as the Commissioner for Children and Young People in Scotland from 18 May 2011.

Alasdair Morgan (Scottish National Party, South of Scotland)

Mr Johnstone, do you wish to speak?

Alex Johnstone (Conservative, North East Scotland)

No. [Laughter.]

Alasdair Morgan (Scottish National Party, South of Scotland)

It is just that a little birdie told me that that might be the case.

As no one else wishes to speak, that concludes the debate on the SPCB’s reappointment motions.

Early Intervention

Alasdair Morgan (Scottish National Party, South of Scotland)

The next item of business is a debate on motion S3M-7923, in the name of Murdo Fraser, on early intervention in health and education.

Murdo Fraser (Conservative, Mid Scotland and Fife)

We are starting rather earlier than had been expected, but I am sure that the chamber will fill up and that other front-bench members will appear in due course. In any case, it is my pleasure to open this Conservative party debate on early intervention in health and education.

It might seem obvious to say that the early years of children’s development provide the basis for all areas of the rest of their lives, but the point is often overlooked in the provision of health and education. Too often, instead of making a concerted effort to provide the best service and care in the initial stages of life, services begin to address problems and issues only when they have developed fully. The importance of early childhood development and the impact of early intervention in determining future health, social wellbeing and educational achievement have been widely recognised, and a large and growing body of empirical evidence has highlighted the importance of child and parental interaction in the early years of life with regard to the child’s physical and mental wellbeing and future development path.

The early years have a huge impact on outcomes for the rest of a child’s life. Dr Philip Wilson of the University of Glasgow, who provided evidence to the Health and Sport Committee in 2009 and to the Finance Committee’s inquiry on preventative spending in October 2010, has highlighted the key role that early intervention plays in the trajectories of young lives. He said:

“there has been an enormous blossoming in the evidence base on ways of identifying early in life the children who are going to follow a problematic and painful trajectory.”—[Official Report, Health and Sport Committee, 25 March 2009; c 1728.]

Investing early in young people’s health and education has been shown to produce a better return on the time and resources spent both in terms of financial capital in skills-based outcomes and having emotionally able young people. Dr Wilson has also said:

“There is robust evidence that expenditure in the preschool years gives the highest rate of return on investment in human capital ... Public expenditure on the under-3s is minimal when compared with expenditure on any other age group ... There is no doubt that early intervention with vulnerable families by nurses is highly effective, and cost-effective.”

The later it is left, the less the investment provides. Given the ability to act early to identify issues and potential problems before they impact on the child’s development, it remains a great mystery why more emphasis has not been put on resourcing all those who work in intervention to safeguard the future of Scotland’s upcoming generations by affording them a solid start in life.

The quality of the child’s first years of life is strongly associated with his or her educational achievements later in life, and investing time and resources in the initial months and years of a child’s learning reaps many subsequent benefits. Moreover, it is clear that conditions in early life have long-term effects on health and wellbeing. Childhood is the key stage for developing resources to underpin adults’ physical and emotional health, social identities and behaviour. For instance, David Olds’s seminal work in the United States on home intervention by health professionals shows that around 30 hours of input between mid-pregnancy and the age of 2 can halve the incidence of criminal behaviour, substance abuse, smoking, absconding and high-risk sexual behaviour by the age of 15, all of which are issues that the Parliament subsequently has to try to address through legislation and intervention.

The Scottish Conservatives are committed to providing early intervention to a universally high standard. For too long, the provision of the best supportive care for young children has been a postcode lottery, and indeed has been available only to those whose health boards have chosen to provide regular contact with health professionals as a matter of course or those who are in the additional or intensive support brackets. As such, the Scottish Conservatives have pledged an additional £20 million a year to recruit, train and maintain Scotland’s health visitors, who we believe are one of our most valuable assets for effective support and intervention.

Members of other parties will rightly ask how we might be able to afford such a measure in the current climate. We in our party have been clear that we oppose the abolition of prescription charges for people such as MSPs who can well afford to pay, as the move will simply take precious resources out of the national health service budget. Restoring a £5 prescription charge would save £37 million, £20 million of which would be allocated to the vital task of expanding employment of health visitors.

We are also committed to investing in improving parenting skills and support for parents and creating more flexible and accessible nursery education provision. My colleague Liz Smith will expand on those points in a few minutes.

I will take a few moments to explain why sustained investment in health visitors is so important. Far from being able to provide a universal and comprehensive service to all parents and young children at present, health visitors are having to focus on a narrowing number of cases. The restructuring of services under “Health for all Children 4”—Hall 4—brought a change in emphasis to health visiting, meaning that the only formal assessment that is available to all children is at six weeks and that only children who are in the additional and intensive care bracket are offered an assessment at two years. Follow-up after two, three or fourth months of age is no longer expected, and families are left without regular contact, advice and support—a potentially dangerous development in the provision of early years care. Changing the focus to place it primarily on children in the additional and intensive care bracket has left thousands of parents every year without the expertise and care from which they could benefit under a truly universal system, forcing them to identify early signs themselves and to approach proactively their general practitioners or other health professionals.

The Royal College of Speech and Language Therapists has highlighted the effects of the demise of universal care. Professor Law told the Health and Sport Committee that, for many years, a large proportion of pre-school referrals to speech and language therapists—between 40 and 50 per cent—was from health visitors. A review after the implementation of Hall 4 saw the number drop to only 15 per cent. Fewer problems are being picked up in the crucial early stages, as health visitors’ time and resources are being channelled solely into supporting those who are in a particular bracket of care.

Richard Simpson (Labour, Mid Scotland and Fife)

I apologise for arriving late for the debate. The point that the member makes about speech and language is even more crucial because of delays in referral. The average age of referral is 15 months older than it was prior to the changes to which he refers.

Murdo Fraser (Conservative, Mid Scotland and Fife)

I welcome Dr Richard Simpson to the debate and thank him for his constructive intervention, with which I agree.

Parents’ response to the situation is clear. When asked in a recent survey by Ipsos MORI whether they thought that health visitors should visit only those parents who were having problems with their child, 91 per cent of parents disagreed. Nine out of 10 parents agreed that they found the advice of health visitors reassuring. A significant 76 per cent felt that they would have missed the help that was provided by the health visitor if they had not had it. Far from supporting those parents, all too often we make the advice and assistance that they need available to them for only a brief number of weeks, which rarely allows the all-too-crucial relational links between parents and health professionals to be made.

Adam Ingram (Scottish National Party, South of Scotland)

Is the member aware of my colleague Shona Robison’s recent announcement of the revision of Hall 4 guidance, which—among other things—addresses the issues that he raises by providing for regular reviews of children on a universal basis, including the introduction of a 24-month review of the child’s development and the nature of relationships? That is an important improvement.

Murdo Fraser (Conservative, Mid Scotland and Fife)

I am aware of the announcement that has been made. My concern is that we need to ensure that it is backed up by resources and the availability of health visitors. If the minister bears with me for a moment, I will expand on that point.

The links between parents and health visitors and between health visitors and GPs are invaluable. Continuous contact must be fostered between GPs and health visitors in working relationships, to provide a universal and non-stigmatising service for communities that links with social work and education to provide a powerful service. Removing health visitors from that equation cannot but limit the reach and scope of the care that is provided.

My concern is highlighted in the statistics, if we look at the number of vital health visitor posts across Scotland. Despite a small increase during 2009-10 in some health boards—notably in NHS Greater Glasgow and Clyde, where there has been an expansion—the overall number of health visitors has fallen across Scotland since 1998.

Shona Robison (Scottish National Party, Dundee East)

It is important that we establish the facts. Mr Fraser is right to say that there has been a reduction in seven health boards, but he is not right to say that there has been a reduction across Scotland. Actually, there has been a 6.4 per cent increase in the number of health visitors. It is also important to say that there has been an 82 per cent increase in the number of public health nurses. We need to be accurate.

Murdo Fraser (Conservative, Mid Scotland and Fife)

I am grateful that the minister is attempting to be accurate, because I am referring to a parliamentary written answer that I obtained from her, which gives the figures. The figure that I quoted is very important: I said that there had been a fall since 1998. Between 1998 and 2005, the number of health visitors in Scotland was more or less steady at around 1,500. There was then a substantial drop in 2007 to just over 1,100. The figure has since come back up, but only to 1,200. Therefore, we are better off today than we were three years ago, but much worse off than we were in the period between 1998 and 2005. The minister should not rest on her laurels, but should accept that there is a serious problem. Even within the period to which she refers, within the past year there has been a fall in the number of health visitors in seven health boards in Scotland.

Each of our 14 NHS boards has a separate strategy on the use of health visitors, which leads to inevitable variation in service delivery across the country. Indeed, some boards—for instance, NHS Highland—are abandoning the training of health visitors altogether, under the belief that the profession may soon become obsolete.

I have been told that the average age of health visitors in Scotland today is 55, and the concern is that, as they retire, they are not being replaced, as health boards try to make savings by not filling vacant posts.

I referred to Dr Wilson earlier. In his evidence to the Health and Sport Committee, he told of the devastating effect that recent policy developments have had on the morale of the remaining health visitors. In its helpful briefing for this debate, the Royal College of Nursing Scotland reports that 61 per cent of health visitors feel underpaid and that 70 per cent say that they are under too much pressure at work.

My colleagues in the chamber will not have failed to notice the emphasis that the United Kingdom Government has placed on the provision of health visitors in health boards across England and Wales. The UK Government has committed to creating 4,200 new positions for health visitors, to revitalising training and recruitment, and to creating a new identity for the profession. That investment south of the border in early years services will result in a doubling of the number of health visitors who are supporting families in England and Wales and will help to secure many healthy and active generations of families and children. This is an area in which Scotland cannot afford to lose out or start to lag behind. Making the effort to invest in these key services now will reduce the need to try to resolve problems that will go undetected if we continue to reduce health visitors’ capacity to help families across the country.

The £20 million investment that the Scottish Conservatives propose would go a long way towards redressing the imbalance in the provision of early years care in Scotland. Through the creation of a truly universal service of health visiting, working with all families throughout the early years of a child’s life, we would be able to offer the support and advice that parents need, and to work towards combating problems before they take root. That widened provision would not mean a move away from increased care for the most vulnerable. The greater number and provision of fully trained health visitors, working in partnership with GPs and health professionals across the community, would serve to provide a greater level of care for all and would allow the most vulnerable to receive the care that they deserve, as well as opening up that care for everyone, regardless of postcode or region.

The benefits of resourcing now for the future are clear. Scotland cannot afford to sit back and watch while children in other parts of the United Kingdom are offered a better start in life while we have the ability, the opportunity and the duty to provide them and their parents with the most comprehensive universal service of early years care that we can offer.

I move,

That the Parliament recognises the importance of early childhood development and the impact of early intervention in determining future health, social wellbeing and educational achievement of individuals; notes the large and growing body of evidence that highlights the importance of child and parental interaction in the early years of life; recognises the vital role performed by health visitors in supporting families in the early years; notes with concern that, in seven NHS board areas, there was a fall in health visitor numbers between 2009 and 2010; supports a national health visiting strategy that ensures that all families, regardless of income, area or need have access to a health visitor service that will provide a guaranteed level of support to families until their child reaches the age of five; further believes that there needs to be greater flexibility in how parents use their child care entitlement; supports a more flexible mix of state, partnership and private provision of nursery school places, and believes that more information relating to good parenting should be made available to all parents through maternity units, early years settings, GP practices and on NHS websites.

Adam Ingram (Scottish National Party, South of Scotland)

We welcome the opportunity to have this debate. However, the motion that we are debating rather implies that we in Scotland have not got the message about the importance of the early years and early intervention—nothing could be further from the truth. The reality is that this Government has already heeded the national and international research on the early years. We have had a well-supported policy in place since 2008. We know that the early years are the most significant period when it comes to making a difference in a child’s life. Some of the most powerful evidence focuses on the significance of early years interactions for brain development and the extent to which that can influence future life chances for children. In this context, early years means from conception onwards.

Our aim is to ensure that the health, social and parenting needs of families with young children are identified early and met by adopting the getting it right for every child methodology. Murdo Fraser’s motion points out that there has been a fall in health visitor numbers in seven health board areas between 2009 and 2010. However, as my colleague intimated, I wish to make Parliament aware that, since this Government took office in 2007, the number of health visitors across the whole of Scotland has increased by 6.4 per cent, the number of public health nurses has increased substantially by more than 82 per cent and the number of children’s nurses has increased by 238 per cent.

Murdo Fraser (Conservative, Mid Scotland and Fife)

Before we leave the statistics, does the minister share my concern that, since 2007, we have seen a fall of 25 per cent in the number of health visitors who are employed by NHS Lothian? Perhaps more important, we know about the budget pressures that health boards are under. What has the Scottish Government to say to health boards about the future employment of health visitors?

Adam Ingram (Scottish National Party, South of Scotland)

NHS Lothian is the test site for our family-nurse partnerships. The member should look at the figures and the situation in the round. In terms of health board commitments, I will allow my colleague to return to the issue in her summing up.

Public health nurses and health visitors are very valued members of the community care team. We remain committed to maintaining their vital contribution to the health of vulnerable groups, particularly children and families. Indeed, the revised Hall 4 guidance to which I referred, which was issued last month, recommends that the public health nurse/health visitor should be the named person in GIRFEC terms for all children until entry to primary school. As members will be aware, the named person’s role is to take initial action if a child needs extra help, which is critical for early intervention.

Of course, maintaining the health and wellbeing of children and families requires multiprofessional and multi-agency working. We are therefore asking all NHS boards in Scotland to adopt a multi-agency approach to community care, utilising a wider mix of skills to ensure that those children and families who are identified as requiring additional support receive the care that they need when they need it. Working with NHS boards, we are looking at ways to increase the capacity of community nursing teams to meet Scotland’s present and future health care needs. For example, we are developing new roles such as advanced and specialist practitioners. As I indicated earlier, we are also testing a family-nurse partnership approach to support young first-time mothers in NHS Lothian, as we are in NHS Tayside.

We are looking at how health care workers can assist school nurses and health visitors by undertaking more routine work to allow those highly trained professionals to focus on where they make the most difference to families and children. We are also working with NHS boards through the modernising nursing in the community board, which aims to provide leadership and vision to support NHS boards in developing and delivering high quality, sustainable and person-centred community nursing services. The board has identified the health care needs of children, young people and families as a priority area.

Mary Scanlon (Conservative, Highlands and Islands)

In its 2009 report on child and adolescent mental health services, the Health and Sport Committee twice asked for urgent action to introduce regular health and development checks. The Government has brought in one additional health check at 24 months. Despite all the teamwork, still nothing is in place for development checks in the three years pre-school.

Adam Ingram (Scottish National Party, South of Scotland)

I take issue with Mary Scanlon’s analysis of the situation. CAMHS have been underfunded for decades and we are now looking at increasing their capacity rapidly.

We are piloting a programme to increase health care capacity in schools, particularly in communities with the most vulnerable children and young people. The programme’s focus is on early intervention at key transitional stages of the child’s life, such as nursery to primary school and primary school to secondary school. I look forward to seeing a report on the programme’s outcomes later this year.

The motion highlights the importance of supporting parents, which I am happy to endorse. The vast majority of our children will develop and flourish with support from their parents and from universal health and education services, but some parents and families struggle and need support. Most of our local authorities have local parenting strategies in place, and there are excellent examples of joint working.

We provide direct financial support to the key national parenting organisations in the third sector and to organisations that provide relationship support, counselling and family mediation to families who face difficulties. Through the play, talk, read campaign, we encourage closer bonding and engagement between parents and their children.

I am delighted to inform Parliament today that—unlike our counterparts south of the border—we have agreed to continue our support for the excellent and much-valued children’s book-gifting programmes that the Scottish Book Trust runs in Scotland. We will provide funding that amounts to £1.05 million, which is a substantial investment in the current financial environment. That is tangible evidence of the importance that we place on children’s literacy and on parents taking the time to read to their children. The Scottish Book Trust has warmly welcomed that investment. Its chief executive, Marc Lambert, said:

“The renewal of Scottish Government support for this universal programme is seriously brilliant news for all children, families and carers right across the length and breadth of Scotland ... It demonstrates how, in contrast to England, the Scottish Government is genuinely committed to ensuring that all children have the best possible start in life.”

It is just over two years since the Scottish Government and the Convention of Scottish Local Authorities published the early years framework, which sets out a long-term vision for transformational change in Scotland. We have recently published a comprehensive report on progress on implementing the framework and there are many examples of progress.

The golden thread that knits together all the Scottish Government’s policy objectives for children and young people is the transformational change programme called getting it right for every child. If the early years framework sets the agenda, the GIRFEC approach is the methodology for delivering it. GIRFEC has been endorsed by the Parliament and has received support from all parties.

GIRFEC establishes a common language and a shared way of identifying concerns and the needs of children and young people. It operates across all agencies and provides the framework into which specialist and targeted services can be integrated. That is why GIRFEC is a central part of the Scottish Government’s commitment to improving outcomes for all children. It articulates clearly the need for transformational change across systems, practice and culture to drive improvements.

The economic case for getting it right in the early years is sound. We have published research—based on data from the Scottish context—that shows the potential cost to the public sector of not intervening early in the lives of disadvantaged children. The research shows that, in the short term, savings from investing in early years services and support, from pre-birth to the age of five, could reach up to £37,400 a year per child in the most severe cases, and approximately £5,100 a year for a child with moderate health and social care needs. In the medium term, the savings—if interventions from pre-birth to age eight are 100 per cent effective—could be up to £131 million a year across Scotland. In the long term, failure to intervene effectively to address the complex needs of children in early life could result in a ninefold increase in costs to the public purse.

I do not underestimate the impact that worsening budget pressures will have on the pace and scale of implementation, at both national and local levels, across the early years agenda. However, for this Government, the case for driving forward this agenda with our partners is indisputable, and it deserves full support from all parties in the Parliament.

I move amendment S3M-7923.3, to leave out from “with concern” to end and insert:

“the establishment of the Modernising Nursing in the Community Board, which is working with NHS boards to ensure that community nursing services in Scotland are fit for the 21st century, and further notes the increase in public health nurses/health visitors during the current parliamentary session; supports the current flexible use and mix of state, partnership and private provision of nursery school places in line with local needs and circumstances; welcomes the fact that the vast majority of Scottish local authorities and their partners have local parenting strategies in place, and endorses the current financial support to the leading third sector organisations that provide information and support to parents, including family mediation organisations that provide assistance to families in difficulty.”

Des McNulty (Labour, Clydebank and Milngavie)

I begin by thanking the Conservatives for choosing the topic for debate. It is an extremely important issue, and the debate allows the different parties to put forward their thinking in advance of the election in May. I assure the Parliament that during the election—and thereafter, whether we are in opposition or in government—early intervention in education and health will be a major issue for Labour. We wish to work with other parties and with health organisations, local authorities and the voluntary sector to implement the strategies and policies that we seem to have in such abundance on this issue.

Although I have lodged a lengthy amendment to the Conservative motion, we are not in fundamental disagreement with the Conservatives—or with the other parties that are represented in the chamber—about what we want to achieve. I can also easily endorse the Liberal Democrat amendment. We all support the early years framework and the other strategic documents to which it is linked: the three documents work together.

We all share concerns about the physiological, psychological and social problems that are associated with the impaired development of children before the age of three, which were drawn to our attention so forcefully by Dr Harry Burns, the chief medical officer. The costs of not intervening early were highlighted by Alan Sinclair and other witnesses in their evidence to the recent Finance Committee inquiry, as referred to in the Liberal Democrat amendment.

If there are differences among us, they are more to do with judgments about the relative effectiveness of different types of intervention and the priority that they should be given. There is another level of possible disagreement that people are probably more reluctant to talk about, regarding the volume of resources that should be made available for early intervention, as opposed to other requirements in the budget. To be frank, I do not think that any of us have been entirely honest about it. People are looking for a step change—a significant shift of resources that will make a difference. We all have to agree: first, that we will do that and, secondly, on how it should be done and on what the priorities within that change should be.

It was noticeable that during yesterday’s budget debate there was almost no mention of early intervention as an area that requires additional resource but, in theory, all the parties are signed up to the Finance Committee report, which advocates investment in preventive rather than reactive measures, and proposes a long-term shift in resources towards early intervention.

We have all the policies and strategies. What we lack is the will to proceed. In my party’s view, that has to change. The report by the Convention of Scottish Local Authorities on progress on the early years framework essentially says that all the ideas are there, but that we are yet to start on the joint working that is needed, and that we still need to get to first base on implementation. Given the scale of the problems that have been identified and the need to take on the issue, that has to change.

We are entering—in fact, we are already in—a period of severely constrained budgets, but it is clear that the social problems that are associated with crime, addiction, worklessness and intergenerational poverty are not going away, but are getting worse. There is a lot of evidence around Scotland to suggest that some of the problems in the worst-affected communities, and for children who are brought up in poor circumstances, are definitely not improving.

We need to do something, and we need to try to stem the tide of young people who are growing up in stressful, chaotic or disadvantaged circumstances. If, as my amendment suggests, we can identify those young people who have serious communication and language difficulties long before they arrive at school, we can take steps to prepare them for education, rather than leaving them to be frustrated, as soon as they get to school, by their inability to learn.

My colleague Richard Simpson highlighted in his intervention that since the changes, children with serious language and communication difficulties are being identified around 15 months later. That is a step backwards at a time when we need to step forward.

Like the Conservatives, Labour believes that we need to provide a much better service to all mums and that health visitors and GPs are crucial. The changes made to the health visitor service mean that, for many families, visiting stops when the child is eight weeks old. Those changes happened under Labour—let us be honest about that. We need to revisit that service and move it forward.

Shona Robison (Scottish National Party, Dundee East)

I will make the same point that I made to Murdo Fraser. The Hall 4 guidance has been reviewed, and the new guidance was launched last January. It supplements the existing guidance, and—to address the nub of the issue—allows that there must be discretion, which is what health visitors were seeking. They did not want to be constrained by guidance that would not allow them to use their professional judgment. I hope that Des McNulty welcomes that.

Des McNulty (Labour, Clydebank and Milngavie)

I welcome that, but I believe that we need to go further. The review makes some serious criticisms of what has happened to the health visitor service. As Shona Robison said, the guidance has been reissued, but we need to go a bit further.

Health support and advice need to be available for longer, although perhaps not at a universal level until age five, as the Conservatives argue: until age three might be more realistic. One of the issues is that we cannot focus all the responsibility purely on the health visitor service. We would argue strongly that greater co-ordination and integration of services is needed: it is crucial that education and health work together.

Christine Grahame (Scottish National Party, South of Scotland)

In the Health and Sport Committee’s report on its inquiry into child and adolescent mental health and wellbeing, we made the point that there is a big role for nursery nurses and nursery schools in integrating with health visitors. As most children now have a nursery place between the ages of three and four, will Des McNulty agree that that is a way forward?

Des McNulty (Labour, Clydebank and Milngavie)

It is a way forward, but if we look at the distribution of budgets, we can see that there has been a decline in the numbers in nursery education and a reduction in the budget for care staff. We need to pay attention to that. It is about priorities, and young children should be more of a priority than they are at present.

We need integrated resources, particularly for those who require intensive support—or who need more than the norm, if I can put it like that. Murdo Fraser came a bit close to saying that we need a universal service rather than a targeted service, but I think that we need both. We need improvements in the universal service, but we need integrated and targeted resources that are directed particularly at teenage mothers and harder-to-reach parents who may be living with health difficulties, social issues or learning problems of their own.

Senior social workers have told me that the children who are most at risk of growing up with multiple problems can often be identified at a very young age, but under current arrangements there is too much time before intervention takes place. All too often, intervention is sporadic, with not enough partnership working at the right time between the different agencies.

As well as health and education agencies—

Mary Scanlon (Conservative, Highlands and Islands)

Will the member give way?

Des McNulty (Labour, Clydebank and Milngavie)

I will just make this point.

It is important that we talk about the voluntary sector too, because it has a major role to play and it could play a much greater part than it does at present.

Mary Scanlon (Conservative, Highlands and Islands)

Does Des McNulty agree that although integration and intervention are critical, identification of the child’s need is most critical? He emphasised nursery staff. Does he agree that they need more support, help and training to identify that need?

Des McNulty (Labour, Clydebank and Milngavie)

I agree with both of those points. Teachers—particularly nursery teachers—make the same point. Intervention is too fragmented and too late. The parents, rather than the children who are brought up in chaotic circumstances, are often seen as the clients of the agency, and the child’s interest is not given the consideration that we—certainly, that I—would want it to be given.

I do not pretend that there are any easy answers, but we need better integration between agencies—particularly health and education—a stronger role for the voluntary sector, and more structured provision of parenting support, which should be designed with the active participation of recent parents to ensure that it is relevant to the people to whom it is directed. If we rethink what has gone wrong in service delivery and identify clearly what we want to put right, we can move in the right direction.

We have the policies and strategies—many reams of paper are available on the issue—but we need action, co-ordination, a clear sense of direction and prioritisation. That approach must improve universal services for parents and children, but it must also target resources at the families and children who most need it. As a Parliament, we must give children the highest possible priority and be prepared to act decisively and quickly when we feel that the child’s interest merits it.

I move amendment S3M-7923.2, to leave out from first “supports” to end and insert:

“believes that NHS boards and local authorities working with third sector organisations and volunteers must give children’s community services more integrated resources; recognises the valuable role being played by Sure Start and Family Centres and expresses concern regarding the impact of funding reductions on low-income families; further believes that health visitors linked with a GP practice and social workers have a key role to play in assessing, advising and supporting the parents of babies and very young children, especially young mums; welcomes the nurse family partnership pilots but proposes that Health for All Children 4 guidance should now be reviewed; considers that families should be partners in determining how services, including parenting support, should be provided; believes that early education and care is vital in providing a positive start for every child as well as in identifying and overcoming barriers to learning such as poor language and communication skills; believes that, where a child is at risk of neglect or abuse, a strict timeline for intervention is required, and welcomes the pilot being undertaken by Glasgow City Council, ensuring that giving every child the best chance in life as well as the protection of the child are the overriding considerations.”

Ross Finnie (Liberal Democrat, West of Scotland)

I welcome the Conservative motion and the opportunity that it gives us to discuss early intervention. Although the motion and amendments have differences of emphasis, they show a great deal of consensus on the broad approach that we seek to adopt.

Coming from the West of Scotland and an area of traditional deprivation, I am conscious that many of the problems that we seek to address are certainly not new. Indeed, rather tragically for this generation of politicians—that includes me—we have failed to address those problems and, therefore, face problems that do not emerge from a single generation but manifest themselves through two, three or, in some cases, even four generations.

The urgent need for us to stop talking and get on with it, as Des McNulty hinted, seems to be clear. However, if it was that simple, we would have done it before. We must recognise that there have been real changes in thinking and outlook. I will make it clear why Liberal Democrats believe that the issue is important and why the thinking has altered.

I was struck by a passage in the Barnardo’s Scotland briefing for the debate. It reminded me of speeches and policy papers that I had heard and seen earlier from my party, but perhaps the message is more authoritative if I draw on Barnardo’s. The passage concerns the simple, elementary fact of

“the importance of the child’s early development for long-term outcomes”.

More particularly, the briefing states:

“Supporting parents and working with the whole family to improve the quality of parent-child relationships in the early years and beyond, is effective in improving outcomes and tackling problems ... Parenting and family support programmes are effective early intervention because they raise the self-confidence and self-esteem of socially excluded parents”

and the young individuals who are affected.

That idea was missing from much of the investment and political time and effort in the 1960s and 1970s. Members should be in no doubt that political parties of all hues have invested huge amounts of time in trying to solve the problems, but they have done so in a structural way. Their approach has had much to do with the physical environment, and they have rather overlooked the essential need to improve the capacity of the individual to regain the self-confidence and self-esteem that are vital if they are to help themselves by being helped to help themselves out of the problem. That is why Liberal Democrats share with other members a real sense of urgency about having to get things right.

I totally accept what the ministers have said about great improvements having been made, but the fact remains that we still have great problems. Those who deal with and are integrally involved with the problems, and even our Finance Committee’s recent report on preventive spending, have not given all of us a clean bill of health. They have been quite clear that there are still issues to be addressed. There is an interesting point in the Finance Committee’s report about the early years framework. Although the committee subscribes to that framework, it asked whether it should be more targeted at the zero-to-three age group as opposed to the zero-to-eight age group. We are all increasingly asking that question. That assumes that there are mechanisms through which those who require that level of support are identified. Mary Scanlon mentioned that in her interventions.

I think that there is general agreement about where we should go, but it is clear that if we agree that we are going to shift our emphasis on to genuine early intervention, it falls to all the political parties to skew their financial and other commitments to match that political ambition. I share Des McNulty’s view on that. That will require us to think carefully about where we are with some of the structures.

The Conservative motion rightly places great emphasis on the importance of health visitors. Richard Simpson can give members a short lecture on RONIC—the review of nursing in the community—as he is one of the world’s experts on it. If time permits, we may get that from him.

Richard Simpson (Labour, Mid Scotland and Fife)

There will be a personal seminar later.

Ross Finnie (Liberal Democrat, West of Scotland)

My serious point is that what was started with the early changes to the health visitor service was done with good intentions. We should not forget that some of the real difficulties that emerged from making those changes, to which the minister and Murdo Fraser have alluded, have caused us real problems.

The service is still under review. The minister has issued revised guidance on Hall 4, and I think that the modernising community nursing board is still due to complete its work, but we know that people throughout Scotland apply things in different ways. We know that NHS Greater Glasgow and Clyde, which does not have a bad record in respect of its employment, does not believe that there is necessarily any relationship between health visitors, GP practices and, much more crucially, the client group—the individual, the young person and the family—for which it might provide that support.

There is disengagement by our respected bodies. As Murdo Fraser said, that calls for a much clearer focus and strategy. The Liberal Democrats support that approach. We have all signed up to GIRFEC, but it is remarkable that, although we want multi-agency support, and for it to sit within the early years framework, people throughout the country still believe that we can simply split up communities and have a disconnect between the GP and the health visitor, but things will still work. I find that remarkable, as do other Liberal Democrats; nobody who has studied the papers could come to that conclusion.

The purpose of our amendment is quite simple. I share the view that it is imperative to have a health visitor framework that is slightly more targeted and seeks to provide holistic support. However, we must widen the debate and recognise that the social, education and health frameworks must be integrated in an holistic approach and that the preventive approach, which was endorsed by the recent Finance Committee report, is how to take that forward. Our amendment is not intended to diminish the importance of the health visitor, but rather to suggest that we take a slightly broader and more holistic approach, and emphasise the critical importance of preventive spending.

We have had to make difficult choices in the current financial climate. If we are to justify to everybody why we should make a bigger investment in the early years, they must see that not only will there be a return for the young people, parents and families, but that we can improve how we spend our money and get a better return.

Liberal Democrats are clear that early intervention is a crucial area of policy. Problems in this area have bedevilled parts of Scotland for many years, which is a tragedy. The people who suffer are not the politicians who make the decisions, but the young people who, generation after generation, are born in circumstances by which they are permanently disadvantaged. That is a blight on our society that Liberal Democrats feel passionately about because there is certainly no liberty in poverty and no liberty in ignorance. The two matters of health and education are important to me and my party, so we support the general thrust of the motion. However, I hope that we will get support for the amendment in my name.

I move amendment S3M-7923.1, to leave out from first “supports” to end and insert:

“agrees with the conclusions of the Finance Committee’s recent inquiry into preventative spending that the current balance of government spending is skewed too much in favour of reactive, rather than preventative, spending; recognises that early intervention has proven benefits not only in health and education but also in other areas such as crime reduction measures, support for carers and services for older people, and supports a long-term shift to sustained investment in a high-quality, preventative approach to the growing social and economic challenges faced by public services.”

Alasdair Morgan (Scottish National Party, South of Scotland)

We now move to the open debate.

Elizabeth Smith (Conservative, Mid Scotland and Fife)

In this hectic season of budgets, election preparation and the endless requests to attend hustings and briefing meetings, there is also the very important business for parliamentarians in interpreting the key messages that come from the main groups that are interested in our respective portfolios. There is a wealth of information in which each group sets out its own manifesto. Reading through those that relate to education, including—interestingly—those that relate to the tertiary sector from where there is perhaps the greatest demand at the moment for additional resources, there is universal acceptance that the early years are paramount, not just because of the health and social aspects that were described by Murdo Fraser in his introduction, but because it is a delicate task to get the balance right between those factors and the child’s education.

It is a given that children invariably fare better when they grow up in a loving, caring and well-balanced environment in which family life is the centrepiece and in which they can flourish, both socially and academically, in the company of their teachers and school friends. It is important to recognise that there is no ready mix of those factors and that success can never be prescribed merely by the actions of Government. That point has been made in each of the thoughtful preceding speeches.

Of course, what Government can do is put in place a raft of policies that help to create a more conducive environment in which parents and their children can thrive and where the education experience, from its earliest stages, is of the highest quality. Apart from ensuring that there is greater support for parents to recognise and adopt their full responsibilities in fulfilling their challenging role in society, we need to find ways of providing a structure of education that can combine excellence with flexibility, greater parental choice and greater diversity, so that the child’s needs and the expectations of the parents drive the system, rather than its being driven by any doctrinaire vision that believes that the state knows better than anyone else.

So, what needs to be done on the education front to complement the health policies that were outlined by Murdo Fraser? First, we need to ensure that we do much better in providing parents with greater choice and flexibility in nursery school placing. I suggest that there is a consensus among all the parties that nursery support is invaluable, not only to the wellbeing and development of the 107,000 children in Scotland who attended pre-school education in 2010 but in providing support to parents who live away from their own parents or relatives or who are raising a child on their own and cannot rely on their partner for support.

That is why we think that there is room for improvement in the current system. Many parents want greater flexibility when it comes to using their entitlements. As a result, some—not all—parents want a wider range of providers. A Daycare Trust report that came out yesterday, shows that the average annual cost of 25 hours of nursery care a week for a child under two is highest in Scotland, at £5,220, compared with just more than £5,000 in England and a little more than £4,700 in Wales. Conservatives argue not only that if there is more choice, parents will have more options in choosing which provision best suits them and their child, but that more robust competition between providers will inevitably lead to an overall reduction in costs, in some cases.

Maureen Watt (Scottish National Party, North East Scotland)

Does the member accept that the changes to the child care element of working tax credit that her party’s Government in Westminster is introducing will mean that 1,280 families will lose an average of £454 in help with childcare costs in the next financial year? How is that going to help?

Elizabeth Smith (Conservative, Mid Scotland and Fife)

The member has made a reasonable point. There is work to be done in that regard and it is important that child care be included in the package. That is something that we definitely need to think about.

Secondly, when it comes to providing greater choice, partnerships need to work properly. Partnership nurseries that involve local authorities and private providers should be true partnerships. Currently, some local authorities are dictating the allocation of places and ignoring official guidelines. Indeed, partnership status has been withdrawn from some private nurseries in Scotland, which means that parents have had to find another partner nursery or risk losing a part-time funded place. In some cases, that is worth up to £1,550 per year for each child. That is a wholly unsatisfactory situation.

Thirdly, we want to work with teachers, support staff and teacher training colleges to ensure that there is greater emphasis on effective training for all teachers and support staff in recognising special needs at the earliest stage. As Mary Scanlon has said, detection is vital. The Scottish Government has done pioneering work in that respect and we give Adam Ingram and his colleagues credit for the Education (Additional Support for Learning) (Scotland) Act 2009, but we need to do more to help teachers and parents to identify problems at the earliest stage, so that there is proper co-ordination of the individual programmes that can help children who have special needs. We need to be aware of the demands from teachers about the important need to address the issue.

Fourthly, we need to address literacy and numeracy at the earliest age. There are many international studies on the theme, the vast majority of which show that an early grasp of literacy and numeracy can heighten a child’s confidence and success, and that children are more likely to flourish when teaching methods are consistent. We look forward to further developments in the area.

Children need and want stability. Without doubt, what happens in a child’s earliest years has the biggest influence on their future. There is a very fine balancing act for Government to achieve, between standing aside to allow society to place its full trust and faith in parents and the family and legislating, where it must, to provide better welfare. Like many other social debates of the modern era, the debate is highly emotive and complex, but it is one from which we must not shy away. If we do not get parenting and early education right, we will not get our future right.

Alasdair Morgan (Scottish National Party, South of Scotland)

For members’ guidance, I advise that any excess time that we have in the debate amounts to less than half a minute per member.

Stewart Stevenson (Scottish National Party, Banff and Buchan)

The tone of the debate suggests that we are heading towards a broad consensus on the issue and a recognition that all members might have lost opportunities to address it. A saying that I have held dear—particularly in recent times—is that someone who never made a mistake never made anything. If we are able to look forward, that is an excellent way in which to go, and I thank Murdo Fraser and his colleagues for giving us the opportunity to debate this important subject.

It is clearly a long-run issue in the sense that we have been engaged in it for decades without having identified everything that we need to do. More fundamentally, it is a long-run issue for our youngsters. Neglect in the early years will result in issues that remain all the way to the end of one’s life. Ross Finnie, in particular, captured that when he said:

“there is no liberty in poverty and no liberty in ignorance.”

When I was a minister, I had the great pleasure of attending a GIRFEC event on behalf of Adam Ingram on 12 March 2010 in Aberdeen. The room was full of several hundred very enthusiastic people who were very switched on. If they are representative of the professionals in the field, our confidence level ought to be seriously high. The presentation that preceded mine was an interesting one about the role of music and how kids interact with music. We were shown videos of children who, in their first day of life, were beating along with a musical beat, showing a degree of interaction. I have no insight into that; I only report what I saw. However, that illustrates that it is never too early to engage a newly born infant with the world and that learning starts, if not in the womb—although who knows?—certainly from the moment that we leave the womb. We must create an environment in which that learning enables people to develop into well-rounded and capable adults.

The multi-agency approach is important. My father was a general practitioner from the 1940s onward, and even at that time he had to work with other practitioners. That not only made a difference to his ability to support his patients; more fundamentally, he was able to bring professionals to the table, although we must accept that the world was much simpler then than the one in which we live today.

The sort of things from which children benefit are diverse. I was lucky enough to be brought up in a house that was chock-a-block with books. Ironically, my ill health in the first decade of my life—I am an asthmatic—helped me because I spent most of my time at home picking up books and reading them. These days, too many children live in houses with no books. The minister’s comments about the provision of books highlighted an important part of what we must do.

Liz Smith talked about literacy and numeracy. We often talk ourselves into thinking that we are innumerate. Many people say that they do not understand numbers; yet, in any bookie’s, we find mathematics that I, a mathematics graduate, am incapable of doing. The guys with the wee pencils behind their ears, working out complex odds on five-way accumulators, can tell one instantly whether to pay the tax in front or behind and how much it will be. People do not realise how numerate they are. I also have a small personal obsession with our failure to utilise the Trachtenberg speed system of basic mathematics, which is a wonderful system for engaging children in mathematics.

We must always support the next generation. I am now almost certainly in the last quarter of my life, and I am conscious—as others should be—of the fact that it is the younger people in our society who will choose the care home in which I will live. If I do not look after them now, there will not be a very good outcome for me. The question that has always engaged us all is that of nature versus nurture. In parts of Scotland, there are generations of people who have not been brought up in a nurturing environment, and there is a clear need to address that.

We have seen that the early years of children’s lives are crucial and that successive Governments have sought to engage on the issue. I very much welcome the contributions that have been made to the debate. There has been unexpected humility, so far, and welcome consensus.

In closing, I make the observation to the Labour Party that I am not entirely sure that four-day weeks in school and the mooted proposal that I heard last week to delay entry to school until the age of six will necessarily help, but I am interested to hear what proposals will be made, by Labour and others, in the coming election.

I am happy to support the amendment in Shona Robison’s name.

Karen Whitefield (Labour, Airdrie and Shotts)

I welcome the opportunity to speak in today’s debate on the importance of early intervention. The Conservatives are right to bring this issue to the chamber. There has been consensus among all those who have spoken that this is a crucial issue for the future of Scotland’s citizens.

I thank all the organisations that provided briefings for today’s debate, and particularly thank Barnardo’s for the information that it provided to me.

We all recognise the importance of early intervention. In the drive to squeeze ever more value from public spending, early intervention’s time may have come. Intervention models, along with shared services, will increasingly become the standard approach to public service delivery.

Properly targeted resources, applied at the right time, can lead to substantial economic and social benefits over the long term. In his opening speech, Adam Ingram pointed out that there are cost-saving benefits to be gained if effective early intervention models can reduce the number of interventions that might be required in the life of an individual by the social work, drug and alcohol addiction services or the criminal justice service, but the issue is not just about saving money. Early intervention is a good thing in itself, not only for the individuals involved but for society. The approach can be relatively costly in the early years of introduction, which is why we need to build a strong case for the view that early intervention delivers cost savings and social improvements over the long term.

Ross Finnie was right to point out that, if the solution to the problem was simple, we would have solved it already. I sometimes think that all politicians are driven by quick fixes, but there is no quick fix for early intervention and no quick return. Politicians of all parties need to recognise that, by refocusing our resources and our efforts into those formative early years, we will get a return, but that return will come not in the next four or five years, but in the next 15 to 20 years. The prize that we will get by directing our efforts towards that end is far greater than most of us can imagine.

I will speak about how the early intervention approach has been used in New Orleans in the area of child protection and child development. I will also briefly mention the pilot project that Glasgow City Council has been developing, which uses the New Orleans approach

The New Orleans intervention model is a foster-care intervention that was developed by Professor Charles Zeanah. The programme is designed to address the developmental and health needs of children under the age of five who have been maltreated, abused or neglected and, as a result, placed in foster care. Sadly, many of our children in Scotland will find themselves in that situation as well. In this model, every child that the courts have found to have been maltreated receives a detailed assessment of each of their attachment relationships and interventions are provided to address the needs that are identified. That includes work on the relationship between the child and its biological parents as well as the relationship with its foster parents. There is a time limit of 15 months, by which time the courts have to make a decision regarding a permanent placement for the child. The decision is formed by the assessments of the attachments between the child and the parents and the outcomes of any interventions that have taken place.

An evaluation has shown that since the introduction of the programme, there has been an increase in freeing for adoption, but that for the children who go back to their birth families—the number is not insubstantial—there are significant reductions in maltreatment both for them and for subsequent siblings.

A seven-year follow-up of 80 children who received the New Orleans intervention has shown that on virtually all mental health measures, graduates of the intervention, whether adopted or rehabilitated, are similar to the general population.

The intervention has shown considerable promise in an overseas setting, but further evaluation is required to determine whether that approach could fit our circumstances here in Scotland. That is why I am pleased that Glasgow City Council is attempting to try out the approach. It is putting together a funding application to introduce the model. We should examine carefully the results of the project to see whether it benefits children in Glasgow and whether it could benefit the rest of Scotland, too.

I believe that much earlier intervention in relation to child protection is not only the most effective approach but is morally correct. Yes, we must ensure and protect the rights of parents, but those must be carefully balanced against the rights of the child to live free from abuse and neglect. Surely that is the hallmark of a modern, progressive society. Sometimes that might mean intervening at an early stage, which could be controversial, but I believe that we should not shy away from those difficult policy decisions. We need to learn from the best examples of child welfare from across the globe and we need to have the courage to be radical in our approach, because Scotland’s children quite simply deserve no less.

Mary Scanlon (Conservative, Highlands and Islands)

I commend Des McNulty for his contribution. Not just the content but the tone of his speech was positive and constructive. It is helpful for us to have joint health and education debates. Too often, we talk about those subjects individually; they are not always as integrated as they should be.

There is no doubt that early intervention, care, advice and support for parents and children can benefit people so much in later years in terms of good health, positive mental wellbeing, self-esteem and life opportunities. We know that—the evidence base supports it—and yet what we have in Scotland is a muddle of approaches: RONIC pilots combined the role of health visitor, district nurse and school nurse in the new role of community health nurse; the family nurse partnership programme is being piloted in Tayside and Lothian, whereby specially trained family nurses provide intensive support for first-time mothers and their babies in deprived neighbourhoods; some health visitors are still linked with general practitioner surgeries; and some health visitors are now being embedded in social work departments.

I called the Royal College of Nursing yesterday, because I was getting a little confused by all those titles. It made it quite clear that health visitors now come under the umbrella of public health nurses, along with occupational health nurses and school nurses. So, when the minister says that we have more public health nurses, that does not necessarily mean that we have more health visitors.

The uncertainty over the future of health visiting over the past decade has undoubtedly resulted in low morale, as revealed in the RCN briefing, with most health visitors feeling underpaid, undervalued and under too much pressure at work. We do not have a clear strategy for or approach to a clearly defined role for health visitors. The Government’s modernising community nursing board is due to finish its work by the end of this year—10 years after the generalist model of family health nursing was started.

As part of the Health and Sport Committee’s child and adolescent mental health services inquiry, we heard about the link between nurseries and health visitors. From my knowledge, in the Highlands, the link is the health visitor’s phone number on the wall, which can be called only if the nursery staff think that a child or parent is in need of a health visitor’s advice or support. There have been occasions when parents have considered that the nursery is interfering by going behind their backs and calling in a health visitor. The current system of leaving it to parents to call a health visitor if they need to see or talk to one simply does not work. If parents do not realise that the child has a problem, the health visitor will not be alerted and they will be unable to offer help and support.

The fact is that the parents who are most in need of help and support are, in many cases, the least likely to ask for it. It is not good enough for children not to be seen by a health visitor between their MMR vaccination at 15 months and the pre-school check at five years—that is three years and nine months with no check. I welcome the health check at 24 months, but I would like to know what is involved in it and who will do it.

How different this could all be if a universal health visiting service was established with standard health and development checks on every child at crucial stages in the early years. That is precisely what the Health and Sport Committee recommended two years ago, but the minister’s response to the committee’s report was disappointing, and I think that the response today is still disappointing. We understand and acknowledge that some parents need much more health visitor input and support, but that should not detract from a basic, universal health service.

In the same report two years ago, the Health and Sport Committee called for urgent action to address

“the problems provoked by changes to the health visiting profession in response to the fourth edition of Health for All Children”.

I am not aware that the Government has attached any sense of urgency to the issue. The Government publication “Towards a Mentally Flourishing Scotland: Policy and Action Plan 2009-2011” does not even mention nursery staff. That said, I am aware that in Moray Council, at least, nursery staff are attending courses on the identification of development and mental health issues. I would like to think that that is happening throughout Scotland ahead of all staff in pre-school education registering with the Scottish Social Services Council in 2014. However, given that the Scottish Social Services Council was set up in 2002-03, it will have taken 10 years for nursery staff to be required to be registered, trained and qualified. I understand that they will be the last profession in the social services workforce in Scotland to be registered. That says something about the emphasis that we place on pre-school provision. Furthermore, I understand that the registration will be subject to staff holding certain qualifications or gaining them within three years of registering, which will take us to 2017.

Even with a universal health visiting service and interventions, there will still be a need for better trained staff in pre-school education to help to identify general and mental health as well as development issues in all children. I listened carefully to what Adam Ingram said about GIRFEC and all the rest. I looked at the publication “Early Years Framework: Progress So Far”, and the section on the workforce states:

“By early 2011 this Group”—

that is, the common skills working group—

“will have agreed a draft common core skill-set for the workforce and will enter a period of consultation.”

I do not see any urgency there. The evidence from Dr—

Alex Fergusson (None, Galloway and Upper Nithsdale)

You must close, please.

Mary Scanlon (Conservative, Highlands and Islands)

Right. Finally, I will say that health visiting is a non-stigmatising service. It is a positive input and approach to the family unit, unlike social work, which can be perceived as a threat or an accusation. If we all work together, we can do more.

Alex Fergusson (None, Galloway and Upper Nithsdale)

I believe that the Deputy Presiding Officer intimated that members could have about an extra half a minute each. I would be grateful if they could stick to that.

Christine Grahame (Scottish National Party, South of Scotland)

Those statements always seem to be made before I get up to speak. Members will be watching the clock now.

I congratulate Ross Finnie and other members on their thoughtful contributions. However, despite Mr Finnie’s extremely interesting point about generational problems, I think that our society has a number of special problems. There are more single parents, more family break-ups, more people with several partners and more siblings who are half related to each other. Parents and, indeed, children have different expectations of relationships. We also have to take into account the pressure on relationships from being part of a materialistic society that puts people into debt and, if we put alcohol and drug addiction into what is already a pretty heady mix, it is clear that we are dealing with a situation that is perhaps worse than it was in previous generations. In that light, I commend to the Parliament the Health and Sport Committee’s very thoughtful report on mental health and wellbeing, which was published on 23 June 2009, and will highlight from it two or three issues by way of background. Of course, many of these points have already been addressed by other members.

First, Dr Wilson from the Scottish needs assessment programme—or SNAP—core working group on child and adolescent mental health told us that neglect before the age of two was the strongest predictor of later childhood mental health and also made it clear that

“Early neglect ... can take many forms ...”

and was not limited to

“neglect by parents whose drug and alcohol problems mean that they are so preoccupied that they cannot connect with the child.”—[Official Report, Health and Sport Committee, 25 March 2009; c 1737.]

Of course, as we heard in evidence, 100,000 children in Scotland live with a parent with a drug or alcohol addiction. In what is a very complicated situation, we have to tackle parents as well as intervening early with children.

No one has mentioned this yet, but in some cases the child will have to be taken from a parent at a very early age. That happens under the auspices of the children’s panel system, in which the child’s best interests are always considered.

Karen Whitefield (Labour, Airdrie and Shotts)

Christine Grahame is right to raise the point, but does she recognise people’s frustration in this matter? The difficulty is that children tend to go back and forth before any decision is taken and children’s panels can be reluctant to take the final decision for the child to be permanently adopted out. Chances are given time and again, whereas the New Orleans model prevents that and ensures that the decision taken is the best one for the child.

Christine Grahame (Scottish National Party, South of Scotland)

I am not familiar with the New Orleans model, but I am familiar with the children’s panel system. I know that children can be taken away from parents at a very early age after a discussion with all parties, because the panel always considers the child’s best interests.

I have a great deal of sympathy with what has been said about the important and specialist role played by health visitors, but we must be practical. As we have heard, many of them are in their late 50s. That is not the fault of the Parliament, let alone the Government; it is simply a fact of life that this professional group is reaching the age of retirement. Moreover, the demographics are changing. The Scottish Borders, for example, has a very large elderly population, which means that more district nurses and fewer health visitors are needed. Nevertheless, we still need health visitors. I realise that both specialisms require different skills and know that it is terribly difficult for people to build in flexibility, but the fact is that flexibility will have to be built in here.

Shona Robison (Scottish National Party, Dundee East)

Does the member share my understanding that nurses coming into the profession want that kind of flexibility to allow them to make career choices as they go through their professional life?

Christine Grahame (Scottish National Party, South of Scotland)

That might well be the case, but I am talking about existing district nurses and health visitors. They have met the Cabinet Secretary for Health and Wellbeing, who was very sympathetic to the fact that, despite the many years of expertise in their own areas, they would be facing difficulties, but I do not think that we can stay in the same position. That said, we should move from health visitors coming in only when they see difficulties towards a more universal approach, because under the current approach they are being stigmatised. I never thought that I would see the day when a health visitor who knocked on someone’s door would be treated like a social worker and rejected. I am not saying that social workers are to blame for that situation, but the family in question would say to the health visitor, “Why are you at my door? What’s wrong?” Previously, it would have been normal for the health visitor to show up. Such an approach was more subtle and less in the face of parents.

In the very brief time that I have left, I will talk about the abolition of prescription charges. I say to Murdo Fraser that, first, most prescriptions are for chronic illness. As we have discussed previously in the chamber, it is impossible to compile a comprehensive list of conditions, so some people would pay for a large number of prescriptions.

Secondly, the Murdo Fraser always cites MSPs’ salaries and says that MSPs should not have access to free prescriptions. However, it is necessary to draw a line somewhere and to say that people who are over it will pay. If I recall correctly, in a previous debate in which I participated, Derek Brownlee came up with the figure of £21,000. That is not a lot of money. People who are ill may have additional liabilities, as they must heat their houses more and must travel to clinics. It is not good enough just to cite MSPs’ salaries—members should cite the salaries of people who would be just over the barrier.

Thirdly, medication is free if people are in hospital. Why should they be charged for it if they take it at home? What principle is in operation there? Prescription charges are an easy hit, but when we examine them, we find that they are not good.

My final point is directed to Ross Finnie and concerns preventive spending, which the Liberal Democrat amendment advocates. However, as we saw clearly yesterday in the chamber, with a limited budget—I will restrict my comments to health—it is extremely difficult to strike a balance between preventive spending and firefighting. We cannot do that with our limited budget. I think that that is my only controversial point for some people; perhaps there were more. The Parliament must have more financial powers, to give us the flexibility to make real social change in Scotland. All of us would love to target women who are pregnant and need assistance, because troubles often start in pregnancy, but we will not be able to do that within the existing financial constraints.

Helen Eadie (Labour, Dunfermline East)

Stewart Stevenson said that the tone of the debate is leading to consensus—yes, on fine words by the Tories, but no, if we take a reality check. Early intervention has always been a priority for Labour, both in Scotland and at Westminster. If I were in the minister’s shoes, I would not take any lectures from the Tories today, based on what they have said down south.

I find it really concerning that in today’s debate the Conservatives cannot or will not protect children’s budgets, although they say that early intervention is a good thing. Murdo Fraser talked about the Conservative Government south of the border. I believe that people should and will want to invest in early intervention, because it is a proven public finance saving. However, the Tories just cannot see that, despite their fine words. I shall expand on that point in a moment.

The Conservatives should take heed of the 2005 Nobel prize winner, James Heckman, who has shown that the economic payback of pre-school intervention is three to six times higher than that of any intervention post-school. The same logic applies to health issues. I have always believed that there is no bigger, simpler or more beautiful idea than that of early intervention. As the Jesuits said:

“Give me the child until he is seven and I will give you the man.”

The idea of early intervention is to refocus the attention of public spending on the earliest years of life, to give all our children the health, emotional and social skills that they require to make the right choices later. Research in the US into the effects of nurse-family partnerships demonstrated that children who receive that kind of intervention have 81 per cent fewer arrests than their peers and that as 15-year-olds they have 63 per cent fewer sexual partners. In its briefing for the debate, the Royal College of Nursing describes the impact of work that is being done in pilots of that nature in parts of Scotland. I welcome that.

However, according to headlines in our national newspapers, under the Con-Dem coalition Government,

“Cuts will force 250 Sure Start centres to close, say charities”.

Murdo Fraser’s colleagues at Westminster are responsible for those horrendous cuts. According to a report that was published earlier this week, to which other members have referred, hundreds of sure start centres face closure, and thousands of others are cutting services and have warned of job losses. Maureen Watt was absolutely right to intervene on working family tax credits. The cuts that I have described are a result of the uncaring Tory approach to policy and cutting budgets. I am afraid that fine words from David Cameron and Nick Clegg in the south have led to weasel actions. Their track record is exactly what Scotland would get from the Tories.

Mary Scanlon (Conservative, Highlands and Islands)

Does the member accept any responsibility on behalf of the Labour Party for the huge mega-billion-pound debts that that party has left the Conservatives to deal with?

Helen Eadie (Labour, Dunfermline East)

Mary Scanlon knows only too well that the world global financial crisis started with sub-prime mortgages in the States. She is being disingenuous if she says that she does not remember that. Anyone who is in denial about that needs to take a reality check, which is the biggest problem that the Tories have in Scotland today.

The cuts to sure start will affect 60,000 families, including families in Scotland. A joint study by the charity about children and families, 4Children, and the Daycare Trust suggests that 2,000 centres will provide a reduced service and 3,100 will have a smaller budget. Staff at 1,000 centres have been warned about the threat of redundancy, according to the survey, which involved almost 1,000 centre managers in England. Those sure start centres are all about early intervention, so we should not mock them.

Frank Field, the Labour MP who is now a Government adviser on poverty and life chances for the Con-Dem coalition, said:

“It is inconceivable that we can make the foundation years effective if Sure Start ... Centres all over the place are ... slaughtered.”

It is claimed that the closures and reduced services as a result of Government cuts could mean that 60,000 families lose their local centre. Frank Field continued:

“Local authorities must seek to employ innovative methods to ensure families—especially the poorest families—do not lose the vital support they need.”

I have a particular concern for disabled children and children with special needs. Parents of disabled children tell us that the major challenge for them is not their child’s impairment, but the fight to secure the services that they need to support them to lead ordinary lives. I urge the Conservative party to make a clear public statement on its policies for improving services for disabled children in the run-up to the election.

Early intervention applies to children of school age or younger who are discovered to have or to be at risk of developing a handicapping condition or other special need that might affect their development. Early intervention consists of the provision of services for such children and their families to lessen the effects of the condition. Early intervention can be remedial or preventive in nature—it can remediate existing developmental problems or prevent their occurrence.

We have heard about the frustrations of the Royal College of Nursing. I agree with Mary Scanlon’s points on that. As a consequence of the evidence to the Health and Sport Committee inquiry into child and adolescent mental health services, the Scottish Government was influenced to change tack on the health visitors policy. As Des McNulty rightly said, we have reams of paper setting out policy direction. However, the Health and Sport Committee found when it took evidence that, although successive Governments have set a clear policy direction, it is evident to all that health boards have not cascaded the policy to practitioner level. The committee has often found that boards elect not to make child interventions.

Hugh O'Donnell (Liberal Democrat, Central Scotland)

I am not sure how to follow that consensual contribution from Mrs Eadie.

Helen Eadie (Labour, Dunfermline East)

It is the truth.

Hugh O'Donnell (Liberal Democrat, Central Scotland)

Rather than commenting from a sedentary position now, Mrs Eadie should have made her comments during her speech.

Previous speakers have rightly made observations on what constitutes early intervention and have spoken in chronological terms about age, years and so on. I would like to take a slightly different tack. For most young people, their status can be influenced at various stages in their lives. Children who may be in a loving, warm and stable family unit of whatever composition for the first four years of their lives can have that changed in the blink of an eye. Therefore, to be too prescriptive in saying what constitutes early intervention and when it should occur on a timeline has the potential to work against the child.

There are a number of early intervention projects in Lanarkshire that deal with young people whose lives have changed, getting in at the first manifestation of an issue. At times, the manifestation is a behavioural change in school. Yesterday, with Dr Simpson, I had the pleasure of being at Niddrie Mill primary school for a presentation by a voluntary sector organisation called Place2Be, which provides a place where children can relax in a confident and safe environment and explore the issues that have manifested themselves in behaviour such as verbal aggression, withdrawal and failure to attend. The children are given an opportunity to speak for themselves. In our contributions to the debate so far, we have not addressed this subject. At any given point—subject to age as far as verbal communication is concerned—children have a right to speak up for themselves. There is no question but that giving them the opportunity to do that has to be a constituent part of what we do in getting it right for every child.

My next observation is perhaps a little more controversial. There has to be a much stronger development of the understanding among the members of the multidisciplinary team of the skills that the other professions bring to the table, including the valuable contribution that the voluntary sector makes. That is a serious concern. We hear—anecdotally at least—that social work and education colleagues collide almost as frequently as party politicians do, because their objectives are different. Perhaps more progress on joint training for social workers and teachers will be helpful. In dealing with early intervention, all parties have to recognise the skills that are brought to the table.

The fly in the ointment of early intervention is that, as Ross Finnie highlighted eloquently, were it simple, we would have done it. One challenge is who holds the purse strings. Regrettably, whether we are in times of financial constraint or plenty, the attitude is, “If it’s no ma budget, it’s no ma responsibility.” As Karen Whitefield rightly pointed out, the short-term approach will not work in this regard. This is an area that I am exploring with my colleague Jeremy Purvis. Our concept of a pupil premium could—with sufficient flexibility—bring together disparate bits of budget and focus them on the child, so that they follow the child at the early stages of intervention and the money is used for the benefit of the child. That would perhaps overcome the problem of people saying, “That’s a health service budget,” and so on.

Christine Grahame (Scottish National Party, South of Scotland)

I am delighted to hear that. When I raised the issue of local authority and health board money following the child—I called it backpacking—in the previous session of the Parliament, the coalition Government rejected it.

Hugh O'Donnell (Liberal Democrat, Central Scotland)

That is an interesting observation. I am not aware of that, as I was not part of the previous Administration. However, we are living in different times.

Christine Grahame (Scottish National Party, South of Scotland)

Yes.

Hugh O'Donnell (Liberal Democrat, Central Scotland)

I would not cast away so readily the suggestion at this stage.

My observation in all this is simple: we need to be very careful that early intervention is seen not only on a timeline—early intervention is not purely chronological. Early intervention should be delivered at the appropriate age and stage, depending on the circumstances of the individual child.

Nanette Milne (Conservative, North East Scotland)

Research has shown that the interaction between a child and its parents early in life is key to that child’s physical and mental development, educational attainment, emotional development and social responsibility as it progresses through childhood. I am in no doubt that investment in child support from birth—indeed, from pre-birth—to school age pays off handsomely in later life.

Those of us who are parents have experienced the joy of early interaction with our children and of seeing their excitement as they discover their surroundings and their responses to the people and things that are around them. We probably did not realise at the time—I certainly did not—how crucial that was for our children’s future welfare and success in life.

I still recall the fun that we had at bedtime sharing with my son the Richard Scarry books that were popular when my son was young—that might date me. My son squealed with delight night after night as he found the little gold bug character that was hidden in the books’ illustrations. I recall, too, the stories that my mother made up for the children when she looked after them—I was lucky enough to have my mother to look after the children on the days when I worked. Her scary introduction to witches and ghosts caused trembling excitement but left the children unscathed, because they were safe in the knowledge that they were secure and would not really be harmed by those wicked creatures. Surely that is how imagination develops and how children learn to come to terms with the world that is around them. To achieve that, they need security and stability.

My children were privileged to have two resident parents and three grandparents who had the time and interest to interact with them. I can only imagine how hard it must be for single parents who live far from their parents and want to do the best for their children but do not have the knowledge, resource or support to give them what they need.

Ross Finnie is right: we face second and third generations of parents who have not received adequate parenting. It is sad that many children live in chaotic households with parents who are addicted to drugs or alcohol and who cannot parent them adequately. That results in many grandparents taking over the care of their grandchildren.

Many such kinship carers do not receive the support that they need emotionally or financially. That applies particularly to informal carers who have rescued their grandchildren from an emergency and who are left literally holding the baby. I know that the Minister for Children and Early Years has engaged with that group of kinship carers, but there is still some way to go to help them. Those people sacrifice much to support their grandchildren and save significant public resources by doing so.

Parenting is not easy. We have not reached the stage at which we can be satisfied that the support for all who cannot give their children the best start in life is adequate.

We have heard from Murdo Fraser about the importance that we attach to a comprehensive health visitor service as part of the primary care team, which can give invaluable support to the parents of babies and young children up to the age of five and can pick up problems quickly when they arise. As a GP, my husband had a high regard for the input of his health visitors, who could identify families who needed extra help or who had problems such as communication difficulties that needed quick investigation. I will not elaborate further on that, other than to say that health visitors are an ideal source of the advice and information that parents need if they are to be the good parents most of them aspire to be.

We also want other sources of helpful, clear and concise information to be made available and readily accessible in all maternity units, early years settings and GP surgeries. We are committed to providing information about good parenting websites via trained staff and information through leaflets and other explicit publicity material.

All three and four-year-old children are legally entitled to 12.5 hours per week of pre-school education, but Liz Smith has explained why more flexible provision and a wider range of providers are needed. Parents should be able to choose the nursery provision that best suits their needs and those of their children.

When children are under three, mother and toddler groups and playgroups are invaluable organisations for bringing parents together and allowing them to share their problems and for allowing children to learn to socialise and play together before they enter the more structured world of pre-school nursery. Many parents enrol their children in those groups. Such groups would benefit from enlisting the help of older people, who could share with younger parents their experiences of parenting and of life and could help them with storytelling, teaching nursery rhymes and playing with the youngsters. They would bridge the generation gap and act almost as surrogate grandparents. That might not be feasible in the current climate of child protection and disclosure, although I have seen excellent intergenerational contact with an older group of children in a community cafe in Aberdeenshire, where the youngsters help the oldies with the internet and in return learn about the history of their village from the first-hand experience of the older generation.

On a different note, and in line with what Karen Whitefield covered in her speech, Barnardo’s Scotland has highlighted for us some of its continuing work to support dysfunctional families, and it has called for more decisive action in responding to people in cases where the support that is available does not appear to be improving outcomes for children. That includes proper consideration of removing the child from the family at an early stage. Barnardo’s has also highlighted the problems that arise from failed attempts to reunite families and the need for timely decisions about a child’s permanent future, such as adoption, which can be a very positive outcome for a child who is permanently removed from its birth family. We would do well to heed the advice of an organisation such as Barnardo’s, which has very practical experience of the problems that are faced by all too many young people.

There is general agreement that early intervention has a positive impact on a child’s ability to achieve its potential, but its provision needs to be more strategically planned and delivered, and in a more integrated way. Scottish Conservatives regard early intervention as a positive and productive investment in our country’s future, which we will treat as a priority, and we will work with other parties to ensure its effective delivery.

Christina McKelvie (Scottish National Party, Central Scotland)

I was delighted to read Murdo Fraser’s motion. It is good to see that he has joined the SNP and others in recognising the importance of early intervention. I was almost persuaded that he was praising the SNP Government for the work that it has done so far in early years provision—and that he was looking forward, as we all are, to a second term of the SNP in government.

I take it that Mr Fraser has read the early years framework as interestedly as I have, and that he is entirely in favour of the fine ideas and concepts that are embodied in it. I know that he reads everything that is produced by this Government, and that he is always persuaded by the fine arguments and eloquent debating style of SNP members, so I know that he will agree with everything that I say today.

It is no exaggeration to say that what happens to children in their earliest years says much about our society and is key to outcomes in adult life. As Helen Eadie has already said, the Jesuits had it in the phrase, “Give me a boy until he is seven, and I will give you the man.” Over the past few decades, research has tended to suggest that there is enormous truth in that. Evidence from education, health, justice and economic experts has leaned towards the earliest years of life as being the most critical for development—much of it suggesting that the Jesuits were in fact taking too long over things.

The Scottish early years framework is about giving children the best start in life. It lays out the journey that the Scottish Government, its partners in local government and practitioners in early years services need to take for the benefit of Scotland’s new and small citizens to ensure that they get the very best and that they grow into the best adults they can be. Just as important is that they can enjoy their time as children. That is something that we seem to forget. Some of us took part in a debate not that long ago on children’s play and the importance of developing that.

In fact, the framework starts even before those wee citizens put in their first personal appearance. It starts in the pre-birth period, which is a recognition of the importance of pregnancy in influencing later outcomes and of the mother and child having a healthy relationship right at the start, so that birth and the beginning of independent life becomes a critical stage of development.

Stewart Stevenson spoke about the impact of music on babies when they are born. Any of us here who has had the privilege of carrying a baby will realise that the baby will usually recognise music and voices before they are born, too.

The framework takes the child to eight years old, covering the transition into primary school—through the infant classes into mainstream schooling. There is a good argument that much of the framework is just as relevant to older children, extending into the transition into secondary school and perhaps even beyond that.

Sometimes, the first intervention that is recognised for a child comes through the children’s hearings system, and it is generally on welfare grounds. Sometimes, issues are picked up not through health or education but through the children’s hearings system. The reforms to that system will allow that to be recognised earlier and some of the reforms in the Education (Additional Support for Learning) (Scotland) Act 2009 also help with the early identification of problems.

As Murdo Fraser will have seen during his lengthy examination of the framework, it is about the very things that he mentions in his motion: the provision of good professionals and their excellent professionalism, the broad interpretation of needs and the provision for those needs in a wide range of settings.

The framework recognises the right of young children to high-quality relationships, environments and services that offer an holistic approach to meeting their needs. That runs across the whole spectrum from play, through learning and social relationships, to emotional and physical wellbeing.

It is recognised in the framework and the underlying approach that, although such an approach is important for all children, it particularly benefits those children and families who require higher levels of support. Providing support at the intensity required and ensuring that children and their parents are neither left in limbo without help nor smothered by the state is a job that must be done on a case-by-case basis. It cannot be decided here in Parliament, nor can it be prescribed in a textbook or seminar. That is where the professionals are at their most valuable, helpful and effective.

The Scottish Government realises that, although we can have as many frameworks, strategies and working groups as we like, it is always the people who are right on the scene who make the difference, as I have found from my experience. We are in a position to create the right frameworks, and the Scottish Government has done that, but that is about the extent of what we can do. We must create the framework, provide the resources and leave those who know what they are doing to get on with it.

I agree with Des McNulty—he may not hear that again in the chamber—that a true holistic approach is the most effective way forward. The strategy, the other frameworks and the legislation that we have created on a cross-party basis in Parliament will enable that approach to work and allow the support to be put in place.

One of the most important things about the framework—and the one area in which the motion may stray from the path of righteousness—is that a big part of the strategy aims to ensure that professionals enable parents, families and communities to develop their own solutions using the public services as required. Remedies are not imposed, nor does anyone take the decisions for those whom they help. Independence is as important here as it is anywhere else, and I am sure that Murdo Fraser has a deep appreciation of exactly how important independence is.

The framework is about ambition—about wanting more for our children, our communities and our nation, and about wanting them all to be better and to be better served. It is about making children’s lives better today so that we all have better lives tomorrow. The changes that had to—and still have to—come in the delivery of our public services reflect that.

I congratulate all those who have been involved in developing all the frameworks, the additional support for learning legislation, the reforms to the children’s hearings system and every piece of legislation that we have put in place to support children, and in bringing all those things to this point. I look forward to seeing continuous improvements in our early years provision.

Rhoda Grant (Labour, Highlands and Islands)

I welcome this debate on early intervention in health and education, which is crucially important to future generations. Every child deserves a good start in life regardless of where and to whom they were born.

When we took evidence in the Health and Sport Committee on spending priorities a couple of years ago, I remember that the evidence was stark. We were told that the health budget should be targeted towards the early years, as those years will impact on a child’s mental and physical health throughout their lives. The children who face the biggest disadvantage are those whose parents are drug or alcohol dependent. Without support, their future mental health suffers because they do not learn resilience. As a society, we have a big job to do to protect those young people.

There is always a dilemma about what form intervention should take. There are those who would remove children from their home where their parents are drug or alcohol dependent, and I have some sympathy with that view. However, history has shown us that looked-after children can be more vulnerable than those who are left at home. A child may be reluctant to seek help and confide in adults if they are afraid that speaking out will lead to them being taken into care and removed from their parents. Parental love is probably the most important thing for a child when they are growing up, but wider family support is also crucial.

Children of addicted parents are likely to suffer from poverty, poor housing and poor nutrition, and they are less likely to participate fully in education. Those are dangerous conditions for a child’s development and welfare, and we often see several generations of the same family suffering from the same problems. Children need the state to intervene to help them to break the cycle, and it will never be a cheap option. The best way of doing that is working with the family. That work must be intensive and continuous, because a lifestyle that has been learned over generations cannot be put right by a couple of short parenting classes. Resources are tight, and finding funding for such intensive intervention is not easy. However, if we do not fund it, the costs to us will be even higher, because it is also clear that the later the intervention, the greater the cost.

I remember the discussion in the Health and Sport Committee in which it was suggested that we should concentrate all our efforts on children and forgo any intervention with the parents, but I find that approach difficult because parents are the most important influence on a child’s life. Helping the parent will ultimately help the child. However, the later in a person’s life that intervention happens, the higher the cost to the person and to wider society. If the intervention comes only when the child grows up and becomes a parent, the problem has doubled.

Therefore, it is imperative that at-risk groups are identified quickly. Other issues besides living in poverty and having parents with addiction problems indicate which children are most at risk. They include living in disadvantaged areas, being brought up in households in which there are poor parenting skills or in which there is conflict and domestic abuse, and living in a home where they are not provided with adequate support, perhaps because of illness or disability.

Health visitors have their part to play, as their intervention with the family during the early years will pick up those issues and they are able to guide parents towards solutions. However, we cannot leave it to one group of professionals alone. If we do that, we will fail. For example, midwives interact with women in pregnancy. Early intervention should start at that stage. Drug and alcohol consumption, as well as a poor diet, in pregnancy can affect the unborn child.

Greater reporting to social work and child protection agencies should be encouraged through continuous professional development within the health and education sectors.

The Benefits Agency also has a role to play but seldom gets involved. Anyone on benefits will be pretty close to poverty. Surely staff in the benefits offices have a role in identifying those who are at risk and pointing them to support services.

A study this week showed that children who had poor diets and ate more processed food at the age of three had lower intelligence quotients in future years. How do we tackle that? We all know that processed food is cheaper. Some families really cannot afford to provide a balanced, healthy diet.

The Labour Party has long promoted policies to help young people in that position. We introduced free nursery care, breakfast clubs and the child trust fund, increased child benefit and introduced tax credits that were designed to lift children out of poverty. The Conservative party in the Parliament has used its debating time to highlight the importance of early intervention. I am grateful for that, but I say to the Conservative members—this is meant to be constructive—that they should try to extend their influence to their Conservative colleagues in Westminster, impress on them the importance of the issue and urge them to stop dismantling the much-needed support that vulnerable families receive. They should ask their Westminster colleagues not to freeze child benefit and to remove the restrictions on family tax credits.

Yesterday, I listened to news reports that child care is more expensive in Scotland. That prevents low-income parents from working and damns their children to poverty. The abolition of the child trust fund also takes money from the most needy in our society. I was also horrified to hear that the Child Support Agency will top-slice absent parents’ contributions to their children’s upbringing. That literally takes the food out of the mouths of children.

The Conservative party would do us all a great service if it used its influence with its Westminster colleagues to stop those policies, but we cannot forget about the cuts that are being imposed on local authorities by yesterday’s SNP Government budget, which the Conservatives and Liberal Democrats in the Parliament supported. The budget will lead to the closure of breakfast clubs, as well as to cuts in the numbers of teachers and support staff—the very professionals who are trained to assess children’s needs.

We owe it to future generations to get it right. By getting it right for every child, we benefit not only financially but as a society.

Jackson Carlaw (Conservative, West of Scotland)

As the session comes full circle, the Scottish Conservatives make no apology for bringing back to the Parliament a debate on the areas that consume the greatest resources: health and education. During the session, we have celebrated the 60th anniversary of the national health service and the people who work in it, but at times we have not always been as honest as we should have been about the fact that outcomes from our health service still fall short of those in many other countries in Europe. We understand that the context is often cultural and historic and that the problem is endemic and deep-seated. That is the context for the debate that we want to have on the importance of early intervention in trying to tackle long-term problems.

I thank Ross Finnie for raising the issue of the Finance Committee’s report, which says that we spend too much time on the reactive rather than the preventive. That was why we opposed the final tranche of the abolition of prescription charges proposed by the Government. That was not for ideological reasons. Too much investment was going into reacting rather than preventing.

No member who has participated in the debate could have been other than fascinated by the glorious tirade that was Helen Eadie’s contribution on what the UK Government is doing. I wonder whether she is opposed to the £10.7 billion extra that will be spent each year on health between now and 2014-15, which Labour voted against and which will produce consequentials for the Scottish Parliament to spend on health, or whether she is opposed to the fall of 3,000 managers and the additional recruitment of 2,000 new doctors in the past nine months, or to the £200 million for a cancer drugs fund. In relation to this debate, I wonder whether she is opposed to the 4,200 new health visitors who are being recruited down south. I say to Ms Eadie that the proper response of the people of Scotland to her tirade should be, “Away and bile yer heid.”

Helen Eadie (Labour, Dunfermline East)

Will the member take an intervention?

Jackson Carlaw (Conservative, West of Scotland)

How can I refuse?

Helen Eadie (Labour, Dunfermline East)

Perhaps the member might have more regard to banking and the fact that his colleagues in Westminster are putting more money in the banks’ coffers—the bankers bankrolled his party’s election campaign—than they are giving to people in any part of the United Kingdom.

Jackson Carlaw (Conservative, West of Scotland)

Ms Eadie is not reading or listening. Some 4,200 extra health visitors are being recruited down south. We should be putting our resources into doing that.

That is why Scottish Conservatives believe that we need a national strategy. Fourteen health boards are adopting a variable approach. If we are going to concentrate on nutrition, which Rhoda Grant mentioned, tackle obesity, ensure that the herd immunisation rates increase, improve the sex education of teenage women in order to avoid pregnancies, or improve the welfare of children, we need a national strategy that concentrates on the development of children up to the age of five.

I enjoyed Des McNulty’s speech, which contrasts with the rather Abba-esque policy of the Labour Party in recent times. I was delighted to see Agnetha, Frida, Benny and Björn on the Labour front benches this morning in addition to Helen Eadie, although I see that Björn has rather divorced himself from the group for some time. I suppose that that is in keeping. Jackie Baillie is not with us this morning. I am willing to be persuaded that there is a non-partisan bone in her body, but I have simply never seen evidence of that. Yesterday, we saw Labour’s unseemly arrogance in thinking that it is entitled to power, but that arrogance was absent from Des McNulty’s speech, in which he was humble enough to say that, whether Labour is in government or opposition, he will work with the other parties in the Parliament to address and improve matters and ensure that we have an effective early intervention strategy.

We have said that we want a national strategy, and we are prepared to see an annual investment of £20 million in that. We want to make that investment because we want a fundamental change in culture.

In previous debates, when I have talked about the need for us to ensure that there is a greater sense of self-responsibility in our approach to health, Shona Robison has characterised that as a threat. It has been seen as an implied threat that would mean that we would withdraw health care from those who do not show that self-responsibility, but I did not mean that at all. Indeed, I commend to Shona Robison the working partnership on tackling carbon emissions that we have evolved with her colleague Roseanna Cunningham. We have resisted the suggestion that others have made that we should put in place a regulatory framework with penalties, because we need to change the culture of people and the approach to carbon emissions. Exactly the same approach needs to be taken to health. We need a national effort so that people become more responsible in their health care, and an early preventive strategy is fundamental to that.

Shona Robison (Scottish National Party, Dundee East)

A very good example of that is the emphasis that is being put on self-management, which is about people being helped to manage their own condition. That is extremely effective.

Jackson Carlaw (Conservative, West of Scotland)

I merely wanted to reassure Ms Robison about what I meant when I talked about the need for a greater sense of self-responsibility.

There are two reasons for that. If, through early preventive strategies, we can improve the health of the next generation, the cost to the health service of that generation will reduce. That is fundamental, because we have a demographic time bomb. The NHS will have to bear all the costs associated with a much older population, so, if we are to succeed in the task of improving the health of the next generation, we need to have a strategy that is effective at early intervention.

A culture shift is required. We need a national strategy for early intervention. We have had the courage to say what we would do and how we would fund it. I believe that it is necessary to produce a generational shift in the dynamics for the future health of Scotland.

Maureen Watt (Scottish National Party, North East Scotland)

I welcome the fact that we are debating early intervention in Scotland, which has such a lasting impact on the course of people’s lives. Study after study has demonstrated that the first few years of a child’s life are critical to their development and the opportunities that they are likely to have.

The presentation that ministers were given by Harry Burns when we were developing the equally well strategy, in which he talked about the holes that can develop in children’s brains as a result of neglect, such as not being fed, changed or put to bed at the right time, will stay with me forever. Although a direct cause-and-effect relationship cannot always be proven, a positive nurturing environment is likely to help a child to develop, whereas all too often a negative environment can make it difficult for a child to succeed in education and can lead to health problems or to crime and antisocial behaviour.

As much as we might wish there to be, there is no single silver bullet that we can use to ensure that every child in Scotland grows up in the kind of environment that we would want. Problems do occur, particularly when families are trapped in poverty, and when there is a risk of that happening, it is critical that any interventions to improve a child’s situation are as effective as possible and are taken as early on as possible. Communities and people who work in them know where those families are. At the same seminar, John Carnochan from the violence reduction unit said that it was possible to identify where in a particular postcode area the problem families were likely to be and where there were likely to be continuing problems.

In my view, early intervention begins at the antenatal stage. Every woman who finds herself pregnant will pitch up at the doctor’s, go for a scan and be offered antenatal classes. Those classes should be not just about the process of childbirth and how to bring up a child in the very early months; they should be an opportunity for social workers and health workers to engage with the mother—at that stage, every mother wants the best for their child—to help them to break the cycle of poverty or drug or alcohol addiction so that they can begin to provide a better life for their child.

Whether it is to address a child’s health, their educational attainment or their behaviour, the earlier that intervention is made to change a child’s circumstances, the more effective it is likely to be in the long term. Although speed is certainly no substitute for quality in such cases, the earlier a positive change can be made when a child’s opportunities are at risk, the better.

As others have said, the alternative is crisis management. Waiting for problems to develop before trying to patch them up is more costly and more damaging to children and the people around them. I know that the Scottish Government has been determined to move away from that approach through measures such as its early years framework and the equally well strategy. Prevention and effective early intervention—addressing issues before things reach crisis point and irreparable harm is done to a child’s potential—are the only sensible approach to improving children’s start in life.

Two years on from publication of the early years framework, demonstrable progress is being made in achieving the shift in attitude and philosophy that is necessary if we are to put prevention and early intervention at the heart of Scotland’s early years strategy. That was highlighted in a recently published report, which also identified further progress that can be made.

It is estimated that if early interventions for children from pre-birth to eight years old were 100 per cent effective, up to £131 million of Scottish taxpayers’ money could be saved in the medium term. Not only is early intervention effective but it represents a more cost-effective option. As is the case for so many issues, it is far more expensive to deal with a crisis than it is to take preventive action.

Against the background of the cuts to Scotland’s budget, which we debated yesterday, such efficiency is more important than ever. The undoubted challenges of recession, unemployment and reduced money for services make the successful refocusing of our strategy on prevention and early intervention even more essential. I welcome the progress that has been made so far. I firmly believe that the approach will stand us in good stead in the coming years.

If professionals co-operate, rather than work in silos, no child should fall through the net, as Ross Finnie said. If all professions work together and enmesh their services, perhaps the mesh in the net will become tighter and fewer children will be likely to fall through it.

Mary Scanlon and Jackson Carlaw should not get hung up on titles. The Royal College of Nursing Scotland said in its briefing for the debate:

“Health visiting services are critically important to the present and future health of families, however, they must not be seen in isolation from the rest of the community nursing team. Healthcare and other professionals must be able to work together to support the development of children.”

It is about all agencies working together. Identification of the most vulnerable families is crucial, and the policies that the Government has identified and is pursuing will bear fruit, if they are allowed to continue during a second term of office. I support the amendment in Shona Robison’s name.

Ross Finnie (Liberal Democrat, West of Scotland)

The debate has been consensual, by and large, with a single exception. I always enjoy Helen Eadie’s staunch and resolute defence of a perfect Labour Party, which sees no evil, does no evil and has done no evil. I gently make the point to Helen Eadie that for bankers, the biggest benefit that they are currently getting is from the interest on the monumental debt that the Labour Government managed to amass, which is the equivalent of a new primary school a day. That is obscene. Governments are right to rein in the debt and to ensure that hard-earned taxpayers’ money does not go to bankers at the rate of a new primary school a day but is used to rebuild the social fabric of the nation.

Helen Eadie (Labour, Dunfermline East)

Will Ross Finnie take an intervention?

Ross Finnie (Liberal Democrat, West of Scotland)

I will be delighted to do so, if it is very brief.

Helen Eadie (Labour, Dunfermline East)

Two words. Lord Oakeshott.

Ross Finnie (Liberal Democrat, West of Scotland)

Lord Oakeshott. Splendid gentleman. I know Matthew well; he is an excellent fellow.

Christine Grahame made an interesting point about there being different relationships and characters, but I do not think that what I said about generational problems and what she said about relationships are mutually exclusive positions, because relationship issues can be traced through three generations of a family. It might be that in the third or fourth generation different relationships and more chaotic lifestyles have developed, but the problems can still be traced back to a failure in our society, which is regrettable.

Another interesting point that Christine Grahame made was on preventative spending. Of course, in tight financial circumstances we will face some difficulties; however, we must use financial methods that are a dashed sight more sophisticated than the information that has been presented to us, as some Government ministers would admit. In its inquiry into preventative spending, the Finance Committee came across a number of examples. A Children 1st report talked about £1 spent on early intervention producing savings of £7 in later years. Another report talked about the estimate of the cost of family intervention projects being around £10,000 to £20,000 per family per year compared with the cost of looking after a child in foster care, which is £25,000 a year, and the cost of looking after a child in secure accommodation, which is £134,000 a year. I agree that there will be pressures, but we need to look more intelligently at the options that are available to us if we are seriously to tackle the problem.

Christine Grahame (Scottish National Party, South of Scotland)

I quite agree that we must have long-term investment. The problem is that the Parliament has budgets only for four years and that we will be unable to plan according to that kind of trajectory unless we are in charge of our own finances.

Ross Finnie (Liberal Democrat, West of Scotland)

I am not entirely sure about the correlation between the two. I know that the SNP thinks that every problem would be solved by our being independent, but let us not spoil the morning by getting into the fiscal autonomy debate.

Shona Robison (Scottish National Party, Dundee East)

Why not?

Ross Finnie (Liberal Democrat, West of Scotland)

Well, we could ruin a good day.

There is now much greater consensus about the importance of early intervention. I do not criticise the current Government, which has travelled in that direction. We all understand that some of the early attempts to deal with the problems simply focused on the wrong area. If we are genuine about recognising the importance of early intervention and the benefits that it can bring, we must take note of the range of issues have been raised in the debate.

It is also important that we take international experience into account. Karen Whitefield was right to draw our attention to the New Orleans example, and there are other examples. We do not need to reinvent the wheel every time that we come upon a good idea. There are many good international examples—including in mainland Europe—that the Parliament should be taking the time to look at so that we can consider implementing them in a constructive way.

Liz Smith talked about the flexibility that is required in nursery places and the partnerships that are needed between the nursery scene and other elements of society. All of that must be woven into a solution, if it can be.

Mary Scanlon described the way in which nursing care has developed as a bit of a muddle. Now that we have been promised a report at the end of the year, the prospect of our getting out of that muddle is better. Nevertheless, as I said in my opening remarks, the three-and-three-quarter-year gap to which she has referred on a number of occasions needs to be addressed.

This has been a helpful and constructive debate. However, now that we have all the reports and a general level of agreement, there must be a clearer direction and greater purpose. There must also be a sense of a shared programme not just within the Parliament, but among the various agencies, local authorities and health boards. We cannot have them all continuing to operate in a disparate way. The Liberal Democrats are very keen on, and much persuaded by the arguments for, local people making local choices. I do not mind their doing that but, for goodness’ sake, we must all move in the same direction and with the same end purpose in mind.

Richard Simpson (Labour, Mid Scotland and Fife)

I welcome this debate and the generally consensual approach that has been taken. None of us could forget the picture that Harry Burns published in his report two years ago of the difference between the brain of a normal child and that of a child who has suffered severe neglect. That is our starting point.

There are 100,000 children living in families with alcohol and drug problems in Scotland, and many more that face other serious challenges. There are 210,000 children living in relative poverty, and that number will increase—children with single parents constitute the largest group within that number.

If we do not achieve the early identification, which members from every party want to happen, before a child is three years old, the consequences for that individual, society, the taxpayer and the budget are appalling: between 3 and 8 per cent of those children will have behavioural problems; exclusions will be higher; there will be more smoking, drug use, alcohol use, antisocial behaviour, underachievement, poor educational achievement and unemployment; and more of them will go to prison, become pregnant as teenagers and be obese. We do not need any more evidence to tell us that.

The Dunedin study, which started in 1972, showed that the overwhelming majority of children who will be in the groups that I have mentioned can be identified before they reach the age of three. Hugh O’Donnell is right to say that we need to get on with the identification process, and I will return to that point in a minute. Dr Wilson, from the SNAP group, also indicated that that is perfectly possible, as Christine Grahame said. If we agree on that point, we must focus the resources on that area.

Ross Finnie invited me to give a lecture on RONIC. I will not, but I will say that it was a well-intentioned blind alley that has delayed progress for this Government and has meant that its achievement has been less than it would have liked.

I agree with Ross Finnie that the system is highly dysfunctional. We need only consider the fact that we have yet to align budgets. We have not got an integrated paediatric health and social care service. That failure is disastrous for individual families. We do not have workforces that are aligned and focused—Mary Scanlon and Christine Grahame talked about some of the workforce issues that need to be addressed.

I want to pay tribute to the Government—as I have done in almost all my speeches—for its attempts to move things forward, including its review of “Health for All Children”, the progress on the early years framework and its work on GIRFEC. However, all of that has yet to lead to any significant achievements. We are only at the stage of refreshing the maternity care framework. Why are we simply refreshing the framework when there are many mothers with drug and alcohol abuse problems and we have only a couple of specialist teams dealing with that? As Rhoda Grant and Maureen Watt pointed out, we should start at the point of pre-delivery, not the point after the child is born, yet we do not focus on that to any great extent. We are losing maternity posts today, even though we have a higher number of births than we had before.

There is much activity—a new maternity care framework, NHS Quality Improvement Scotland’s forthcoming pathway of care for vulnerable families, a forthcoming national syllabus for parents and the new guidance on Hall 4—that is about to take effect. However, if we go back further, our teenage pregnancy rates are huge. The healthy respect programme has been in place for many years but it has achieved nothing in terms of outcomes for teenage pregnancy. However, in Oldham, through a focused approach, there has been a 29 per cent reduction in the number of teenage pregnancies, and that is not the only area in England where a similar approach has been hugely beneficial.

The family-nurse partnership pilot arose from one of Tony Blair’s papers back in 2004. Here we are, seven years later, with two pilots costing £1.6 million and supporting 145 families. That is great, and in time we might see that the cost is low relative to the costs that would have developed later on, but it is still £10,000 a family. We will see whether the approach works.

Reference has been made to the New Orleans programme. As a practitioner in adoption and fostering for 18 years, I was repeatedly appalled by the fact that children went in and out of care again and again, and their attachment was never assessed. Without attachment, individuals will not develop properly, so the New Orleans programme might be helpful to us in that regard.

I have had a lucky week, as my new grandson has been born. He is very small—less than 5lb. The breastfeeding nurse in Wishaw general hospital has been hugely helpful in supporting my daughter-in-law, but the nurse told me that the 22 breastfeeding nurses in North Lanarkshire will be made redundant at the end of March—another successful pilot down the tubes. We are pilot-ridden in this Parliament. We have all been trying our best, but the pilots are not good enough. We have to roll things out.

The sure start issue is important. If we do what England is doing under the Tory coalition and have a third of our sure start centres close, that will be bad. That was the point that Helen Eadie was trying to make.

Hugh O’Donnell talked about Place2Be—I am wearing the badge today—which runs a hugely successful but inexpensive programme that helps schoolchildren.

Christina McKelvie, Maureen Watt and others made the point about integration. We have a dysfunctional system that is not integrated. There are separate records on the same child for GPs, health visitors, social work and nursery schools. We must get to grips with that.

I welcome this debate and I support our amendment.

Shona Robison (Scottish National Party, Dundee East)

I certainly welcome the contributions to this morning’s important debate. It was very consensual in the main, with one notable exception—as always.

I want to take a moment to dwell on a bit of an uncomfortable truth. I say this not in a partisan way—even though it is me saying it—because it applies to us all. There is a bit of an irony in the fact that we are having this debate the day after the motion on the budget was passed, because throughout the negotiations with every party in the budget process, the early years and early intervention agenda was never raised. I want to dwell on that for a moment. Perhaps what Karen Whitefield said has some truth to it: we all want short-term outcomes and gains for the things on which we choose to spend money, but this is an area in which that clearly does not happen. Perhaps when we were all talking about our priorities during the negotiations, that was somewhere in our mind, but we must challenge ourselves on that. It is worth us all reflecting on it.

If we are truly to translate what we all say and believe—and there is clearly a consensus around this—into action, we will require collectively to make some difficult decisions about where not to invest. Murdo Fraser suggested that we should not invest in abolishing prescription charges, but why prescription charges? It could have been any of the things that were put forward as alternatives to the budget. I hope that Murdo Fraser takes that point in the spirit in which it was intended.

We all have something to reflect on. I agree with the point that a number of members made about successive Governments having had the best of intentions. Richard Simpson is right to some degree: a lot is happening, but perhaps too much is happening and what is happening is too disparate. Perhaps we need to reach conclusions about what we think will work and do that well everywhere. That is difficult, given some of the governance arrangements in our key agencies, but perhaps we need to begin to think about some of those issues. I will go on to say a little bit about why I think that the family-nurse partnership is a good candidate for that.

In January, I launched a number of key documents that underpin our commitment, some of which have been referred to already: “A Refreshed Framework for Maternity Care in Scotland”; “Reducing Antenatal Health Inequalities”; “Improving Maternal and Infant Nutrition: A Framework for Action”; and “A New Look at Hall 4—The Early Years—Good Health for Every Child”. All that is good and we are going in the right direction. I suppose that the challenge is to make it happen and to overcome some of the workforce issues, where integrated working is not happening as we would like.

Richard Simpson ended on the lack of joined-upness. Interestingly, if we look at Highland, where a lot of interesting things are going on, we see that there the GIRFEC model is fully implemented. That model very much overcomes the problems that Richard Simpson mentioned with different records and a lack of communication, which are so significant for child protection. The challenge is to ensure that GIRFEC is happening everywhere, and that is not without its challenges. We know what works, but we need partners throughout the country to make GIRFEC the priority that it should be.

Richard Simpson also talked about the alignment of professionals—such as paediatricians and paediatric nurses coming together with social care staff—and how we can make that happen. Again, interesting work is being done on that in Highland under the lead agency model. There has been a lot of focus on the adult social care element of that, but there has been less attention on the fact that children’s services are also coming under one roof. There might be something in that. We talk about people working together, but perhaps they actually need to be together to make things work. Perhaps we need to rethink how we structure the workforce.

I will make a further comment on the subject of the workforce before it goes out of my mind. A few comments have been made this morning about who the workforce is in this important area. Christine Grahame, I think, made the point that the workforce is not just a health visiting workforce but must be seen in its broader context. There is a reasonable story to tell on that. The number of district nurses has gone up by 544 since 2007. There are another 150 public health nurses, another 123 health visitors and, indeed, 71 more school nurses. Those of you who are quick at maths will realise that that means that we have nearly 900 additional staff whose focus is very much on this area.

The question is whether they are being deployed in the most effective way, because it is what we do with the workforce that counts, and I think that there are some issues. We await with anticipation the modernising community nursing board’s report, which will be published at the end of the year, because we have to take a hard look at how we deploy those resources, the training that staff receive, the skill set that they have, and what we expect them to deliver and prioritise. We need to be clear about that.

I will touch briefly—because I am running out of time—on family-nurse partnerships. I take on board Richard Simpson’s point that the programme is expensive, but the best programmes are not always the cheapest ones. The evidence that we should acknowledge is not necessarily Tony Blair’s report on family-nurse partnerships but the huge amount of American evidence that shows that, over the lifetime of the child, the investment undoubtedly produces benefits. Under the programme, the vulnerable family has a close relationship with the nurse, who is often the only stable influence on the family, because they might not have the granny who can give advice and there might not be anybody else around. The nurse can be a solid rock and open doors not just on health matters but on many other issues that the family will face. There is solid evidence that we reap the benefits when the child reaches their teenage years, so I am a fan of the family-nurse partnership approach.

Trish Godman (Labour, West Renfrewshire)

You should be finishing now, minister.

Shona Robison (Scottish National Party, Dundee East)

I think the approach works. We look forward to doing more with it, and I think the evidence will speak for itself.

Murdo Fraser (Conservative, Mid Scotland and Fife)

I thank everyone who has spoken in what has been a largely consensual debate. I will try not to single out Helen Eadie—although I might say something later if I have the time.

What was important was to achieve a proper consensus on the importance of early intervention. As various members have pointed out, an election is coming up in less than three months and, no matter what party or combination of parties might be in government, everyone needs to understand that this issue is vital.

Opening for the Government, Adam Ingram referred to the early years framework and the review of Hall 4. After listening with great interest to Christina McKelvie’s request that I agree with the Government, I will agree that I agree with a lot of the early years framework, but I still believe that we need to do more in specific areas. For example, as Mary Scanlon pointed out in her powerful speech, a 24-month health check is simply not enough. We need pre-school development checks. Indeed, we should not rely on a reactive approach but should take an interventionist approach. It might be unusual for a Conservative to say such things, but I think that intervening more in this area will pay dividends. As Mary Scanlon also made clear, there are too many different approaches in Scotland. We need a universal service—indeed that is, for us, the key issue. Although I see merit in the Labour, Liberal Democrat and Government amendments, I cannot accept any of them because they delete from our motion the reference to a national health visiting strategy, which, for us, is the single most important point in this debate.

In a very good speech, Des McNulty raised a number of fair points and I certainly agree with his statement that there are large areas of agreement in this policy area. The key message that I took from his speech is that we know what we should do, but we must now make it happen. Perhaps we have had enough strategies; now we need delivery. He very fairly accepted that the changes to Hall 4 introduced by the previous Administration had not been beneficial and that it was time to think again. As for the debate about a universal versus a targeted service, I want to reassure Mr McNulty that we are not saying that we should not target resources. Instead, we want both; we want to ensure that a service is available to all, with an additional resource for the most vulnerable. I also agree with Des McNulty and, indeed, Hugh O’Donnell on the importance of the voluntary sector, which will play a huge role in delivering this agenda.

Des McNulty, Ross Finnie and a number of other members mentioned the importance of preventative spending and referred to the Finance Committee’s report on the subject. In this respect, Shona Robison was right to point out that the issue did not feature in the budget discussions, which I believe illustrates one of the challenges that we have to face. We are all under pressure from constituents to deliver on certain policy areas and funding for bursaries, housing or whatever, but the fact is that this important agenda gets overlooked because we will not see any of the benefits of spending this money until many years down the road. If we are to introduce preventative spending, we have to ask ourselves what we will stop spending money on today to fund something that will produce benefits tomorrow. That challenge, which faces all parties in the chamber, will not be solved as a result of this debate or, I suspect, any time soon.

In its briefing, the RCN draws attention to the various changes in approach that have been made. It points out, for example, that the RONIC pilots were not progressed; that the modernising community nursing board, which was introduced by the Scottish Government, is due to finish its work at the end of the current year, after which a clear way forward for community nursing should be set out; and that this is creating uncertainty in the nursing profession and among health visitors. All that those people are looking for is certainty and a clear way forward.

Liz Smith and Nanette Milne pointed to the importance of education in early years. As we know, nursery education is vital; however, the current set-up does not suit all parents, which is why we are calling for greater flexibility. Moreover, as a number of members made clear, by the time a child reaches the age of three, it is already too late to intervene effectively and deal with many of the problems that we need to address. As a result, although nursery is important, waiting until children get to nursery before intervention takes place is not the answer.

Parenting skills are vital. There is nothing automatic about having good parenting skills. In most cases, such skills are passed down from generation to generation, but we know that many families do not have that benefit—it simply does not happen. That is why support for parenting initiatives is essential. There are tremendous examples of good work that is being done by voluntary sector groups—Barnardo’s and Care for the Family are two that come to mind—and which provides support for families that need extra help with parenting. We should encourage that. We do not need massive new quangos to be set up, or even massive new state funding—we need support for the voluntary sector projects that are providing those vital skills.

I have a moment to deal with the points that Helen Eadie and Rhoda Grant made about the coalition Government. I gently remind Helen Eadie that we are making cuts today because the previous Labour Government left us with the worst set of public finances in the industrialised world. When we talk about cuts, let us not forget that the Labour Party, if it had remained in Government, would have cut two thirds of every pound that the coalition Government is cutting.

Rhoda Grant rose—

Trish Godman (Labour, West Renfrewshire)

The member does not have time for interventions.

Murdo Fraser (Conservative, Mid Scotland and Fife)

When we talk about early intervention, let us never forget Labour’s legacy to every child in this country. Every baby who is born in Britain today is saddled with a debt of £22,300, thanks to the debt legacy that the Labour Party left.

To quote Des McNulty again, we have policies and strategies, but what we now need is action. Today we have proposed solutions on health visitors, nursery education and parenting. Others have different ideas, which is fair enough. One of our major concerns is that we do not fall behind what is happening south of the border. The UK Government is creating 4,200 new positions for health visitors—a doubling of the number of health visitors who are supporting families in England and Wales. In health and education, people in England and Wales benefit from having the Conservatives in government, at least in coalition. How much we look forward to May, when people here in Scotland will have the same opportunity.

Scottish Parliament Election (Votes for Prisoners)

Brian Adam (Scottish National Party, Aberdeen North)

1. To ask the Scottish Government whether it expects prisoners to be allowed to vote in the 2011 Scottish Parliament election and what impact this will have on the Scottish Prison Service. (S3O-12926)

Jim Mather (Scottish National Party, Argyll and Bute)

The Scottish Government does not agree that convicted prisoners should be able to vote while they are in prison, but that is a matter for the United Kingdom Government. Westminster legislation is required to change the franchise for the Scottish Parliament elections. No change will be made before May, so convicted prisoners will not be able to vote in the forthcoming Scottish Parliament election. Overall, the Scottish Government is keen to ensure that the burden that any change places on the Scottish Prison Service, the Scottish Court Service and those who administer elections is kept to the minimum.

Brian Adam (Scottish National Party, Aberdeen North)

Will the minister confirm that any claims that are brought by prisoners will fall to be contested by the UK Government?

Jim Mather (Scottish National Party, Argyll and Bute)

Indeed. Any claims that are brought by prisoners will fall to be contested by the UK Government, which will have to pay any compensation that is ordered by the courts. That is a given fact.

Jeremy Purvis (Liberal Democrat, Tweeddale, Ettrick and Lauderdale)

Does the minister believe that convicted criminals who are serving a community part of their sentence should have the ability to vote?

Jim Mather (Scottish National Party, Argyll and Bute)

That is another debate that must happen at Westminster. We look forward to that and to the live court cases on the matter that are under way at the moment, including Toner v United Kingdom in the European Court of Human Rights.

Unemployed Young People (Edinburgh)

Sarah Boyack (Labour, Edinburgh Central)

2. To ask the Scottish Executive what support it is providing to help young unemployed people in Edinburgh back into work. (S3O-12957)

Angela Constance (Scottish National Party, Livingston)

The Scottish Government provides a range of support to help unemployed young people back into work across Scotland, including in Edinburgh. For example, Skills Development Scotland has increased the level and range of training places in the city, better to meet local need and consistent with the Government’s wish to ensure that young people have every opportunity to improve their job prospects by staying in learning post-16.

At the end of last year, we announced a European social fund grant of £64.6 million towards 21 strategic projects worth £168 million. A joint bid from the City of Edinburgh Council and Midlothian Council received £3.96 million directly from that allocation, which will deliver employability and training services for the unemployed, the lowest paid and the socially deprived, ranging from early engagement through to in-work support and skills development, over two years from 2011 onwards.

Sarah Boyack (Labour, Edinburgh Central)

I am sure that the minister shares my concern about the 17.2 per cent of young people in Edinburgh who leave school and go straight on to the dole. The City of Edinburgh Council has alerted us to the fact that, because of an anomaly, £2.2 million has been removed from employability training in Edinburgh. We are disappointed that, to date, the Scottish Government has not accepted that there is an issue. Will the minister consider the potential job losses that would affect 3,500 vulnerable young people in Edinburgh, as vital services from a variety of providers would be removed? Will the minister step in, consider the issue and resolve to act?

Angela Constance (Scottish National Party, Livingston)

The funding to which Ms Boyack refers was additional time-limited funding of £2.2 million that was given to the City of Edinburgh Council for 2009-11 to address regeneration, employability and poverty. I stress that it was additional and time-limited money. Nonetheless, I share her concern that Edinburgh has the highest percentage of unemployed school leavers, although I express my surprise that Ms Boyack and her colleagues yesterday voted against 25,000 modern apprenticeships, 46,500 training places, 1,200 additional college places, a job fund to be delivered through the voluntary sector, £15 million for further education bursaries and the retention of education maintenance allowance, all of which would improve the prospects of young people throughout Scotland, including Edinburgh.

Robin Harper (Green, Lothians)

I share Sarah Boyack’s concerns. Is the minister aware of the recent report from Citizens Advice Scotland, which shows that young people are now three times more likely to be unemployed compared with the rest of the working-age population? Given the urgency of the situation, has the minister had the opportunity to explore ways of developing a microcredit finance scheme for young people as a way of tackling youth unemployment? She will remember—

Alex Fergusson (None, Galloway and Upper Nithsdale)

Quickly please. It is a supplementary question, Mr Harper, not a speech.

Robin Harper (Green, Lothians)

I will stop there.

Angela Constance (Scottish National Party, Livingston)

I will be brief. We are considering the microcredit scheme. It might be of reassurance to Mr Harper to know that training programmes in Edinburgh and the Lothians are on the increase. That includes modern apprenticeships, get ready for work and training for work, as well as other programmes including access to industry, passport 156, ProjectScotland and so forth.

Preventive Work (Vulnerable Young People)

Christina McKelvie (Scottish National Party, Central Scotland)

3. To ask the Scottish Government what importance it places on preventive work with vulnerable young people at risk of becoming involved in criminal or antisocial behaviour. (S3O-12943)

Fergus Ewing (Scottish National Party, Inverness East, Nairn and Lochaber)

The Scottish Government places high importance on preventive work with vulnerable young people who are at risk of becoming involved in criminal or antisocial behaviour. We are committed to addressing the causes as well as the effects of youth crime and antisocial behaviour, with a clear focus on prevention and early intervention. There is broad consensus among key stakeholders that that is the correct approach. Data published in the “Scottish Policing Performance Framework: Annual Report 2009-10” suggest that the approach is starting to show results, with recorded youth crime falling by 12 per cent between 2009 and 2010.

Christina McKelvie (Scottish National Party, Central Scotland)

I am encouraged that the minister recognises the important work that many local organisations are doing to divert at-risk young people away from potential criminal behaviour. An example is the highly innovative drama project the street, which is run by Regen:fx Youth Trust in Hamilton and which was singled out as an example of excellent practice in the recent report by Her Majesty’s Inspectorate of Education into South Lanarkshire Council’s child protection services. I have been lucky enough to see that project. We know from recent comments by Labour’s justice spokesperson that Labour would divert the very successful cashback for communities fund, which helps to finance such vital work, into the general policing budget.

Alex Fergusson (None, Galloway and Upper Nithsdale)

Question, please.

Christina McKelvie (Scottish National Party, Central Scotland)

Will the minister reassure me that an SNP Government will protect cashback for communities and continue to invest in crime prevention work with young people?

Fergus Ewing (Scottish National Party, Inverness East, Nairn and Lochaber)

I am aware of that excellent scheme in Hamilton and I congratulate all who are involved.

We shall seek to protect the cashback scheme by maximising the amount of money that we recover from drug dealers and organised criminals throughout Scotland, £26 million of which has been used in the cashback scheme by the Government to help give 300,000 young people across Scotland choices and chances in life. We are determined that the scheme will continue for the next four years, as it has been a success for the past four.

Aberdeen City Council and Aberdeenshire Council (Funding)

Nicol Ross (Liberal Democrat, Aberdeen South)

4. To ask the Scottish Executive what action the Cabinet Secretary for Finance and Sustainable Growth has taken following his commitment to look again at funding for Aberdeen and Aberdeenshire councils, as reported in The Press and Journal on 25 January 2011. (S3O-13004)

John Swinney (Scottish National Party, North Tayside)

The Scottish Government is always open to suggestions for improving the local government finance distribution formula. Suggestions for future settlements will be considered jointly with the Convention of Scottish Local Authorities, on behalf of all 32 local authorities, as part of the normal consultation process.

Nicol Ross (Liberal Democrat, Aberdeen South)

As the cabinet secretary knows, I have been campaigning for all councils to receive a minimum of 90 per cent of the average Scottish funding. Does he agree that that would give Aberdeen Council more than £25 million extra per year, thereby dramatically improving its current crisis funding situation? Today, Aberdeen Council will pass a budget that will cut vital services such as education and care for the vulnerable, making hundreds of staff redundant. After four years in office, the cabinet secretary has given Aberdeen Council and other councils lots of warm words and sympathy, but no action. Will he come to Aberdeen to meet me, my fellow MSPs and council leaders and give a commitment that will deliver real and substantial change?

John Swinney (Scottish National Party, North Tayside)

As Nicol Stephen knows, we met to discuss those questions when he fully and properly advanced the suggestion that he has reiterated to Parliament today. I understand the merits of the proposal, but applying a threshold of 90 per cent would require either the shifting of £120 million of resources within the local government settlement, or the addition of £120 million to the local government settlement. The arrangement could not come about without significant cost.

Clearly, all local authorities face very challenging decisions in the current funding environment, which is, of course, the product of the decision that was taken to reduce public expenditure within the United Kingdom. The budget that the Parliament passed yesterday gives local government in Scotland a much better deal than local government is getting south of the border. While I appreciate that decisions are challenging for local authorities, there is a strong base for local government to take sensible decisions about the priorities for the public.

National Health Service (Access and Support Budget)

Helen Eadie (Labour, Dunfermline East)

5. To ask the Scottish Executive what discussions the Cabinet Secretary for Finance and Sustainable Growth had with the Cabinet Secretary for Health and Wellbeing prior to reducing the budget line for access and support for the national health service from £151.3 million in 2009-10 to £102.8 million in 2011-12. (S3O-12962)

John Swinney (Scottish National Party, North Tayside)

I meet the Cabinet Secretary for Health and Wellbeing regularly to discuss NHS funding, including funding for reducing waiting times.

NHS Scotland has made significant progress since 2007 in delivering shorter waits for patients, with targets being delivered earlier than scheduled. That excellent progress has allowed the Scottish Government in 2010-11 to reinvest £21 million of access support funding into other NHS front-line services. We have also transferred from access support a total of £29 million from 2010-11 directly into the baseline allocations for territorial boards. The Scottish Government has ensured that the total 2010-11 allocation for access support of £101.3 million has been carried forward into 2011-12. That funding is being provided despite the tightest financial settlement since devolution.

Helen Eadie (Labour, Dunfermline East)

Will the cabinet secretary please take note that, along with my fellow Fife MSPs, I have campaigned for some time in Fife on a variety of issues, particularly access to treatment? Some patients are denied any treatment whatever under the national health service, particularly in the fields of in vitro fertilisation and bariatric surgery. Also, in a recent incident, a patient lay on a trolley in a Fife accident and emergency unit for 23 hours. Will the cabinet secretary please give priority to Fife in his deliberations?

John Swinney (Scottish National Party, North Tayside)

Helen Eadie will be aware that resources are distributed to health boards on the basis of a formula that has been widely agreed.

Ms Eadie referred to two specialties. I am advised that they both involve many challenges but that progress is being made. I assure her that the Cabinet Secretary for Health and Wellbeing pursues such issues actively. I am sure that further progress on those matters will be made.

Employment Legislation

John Park (Labour, Mid Scotland and Fife)

6. To ask the Scottish Executive what discussions it has had with the United Kingdom Government regarding recent proposals to amend employment legislation. (S3O-12984)

Jim Mather (Scottish National Party, Argyll and Bute)

Senior Scottish Government officials took part in discussions with their UK Government counterparts on 14 December 2010.

John Park (Labour, Mid Scotland and Fife)

Will the minister share the context of those discussions? That would be helpful. I am concerned about proposals to change the threshold for full employment rights from one year to two years. I am interested in the Scottish Government’s approach to that. Does it support such measures from the UK Government? If not, what will it do as an employer to maintain minimum standards in employment rights?

Jim Mather (Scottish National Party, Argyll and Bute)

I acknowledge that Mr Park has been involved and interested in the matter for a long time. I value his input and I would be keen to talk with him further about the subject.

Scotland has the regulatory review group, in which the Scottish Trades Union Congress is heavily involved, to promote the principles of better regulation. We are also undertaking a mapping exercise to determine which employment laws have an impact on devolved policies.

As I said, I am open to having a further discussion with Mr Park to cover as many mutual interests as possible.

John Wilson (Scottish National Party, Central Scotland)

Will the minister confirm that, instead of undermining workers’ existing employment rights, employers should be reminded of their obligations—particularly in relation to short-time working and redundancy legislation? Will the Scottish Government use all the resources and influence that are at its disposal to ensure that all workers’ employment rights are protected in these difficult economic times?

Jim Mather (Scottish National Party, Argyll and Bute)

The matter is of course reserved and we do not yet have detailed proposals from the UK Government. However, the Scottish Government will—as ever—act in the best interests of the people of Scotland. Our newly approved budget is evidence of our capacity to support individuals, communities and economic growth concurrently. That will continue as we tackle the issues that have been raised.

Kintore Station

Mike Rumbles (Liberal Democrat, West Aberdeenshire and Kincardine)

7. To ask the Scottish Executive what discussions it has had with Network Rail regarding the reopening of Kintore station. (S3O-13001)

Stewart Stevenson (Scottish National Party, Banff and Buchan)

Transport Scotland commissioned Network Rail to deliver an initial feasibility study on how to deliver improvements to the Aberdeen to Inverness railway line. The study identified proposals for significant infrastructure enhancements, including potential new stations at Dalcross and Kintore. Discussions are taking place between Transport Scotland and Network Rail on the findings and the way forward.

Mike Rumbles (Liberal Democrat, West Aberdeenshire and Kincardine)

Network Rail submitted to Transport Scotland a report on proposals for the Aberdeen to Inverness railway line, as the minister said. Aberdeenshire Council’s director of transportation and infrastructure says that he has not seen that report but that discussions that he has had with Network Rail suggest that Network Rail does not favour the early construction of a station at Kintore. Will the minister make the Network Rail report public? Will he make a commitment today to give the go-ahead for that vital north-east transport project?

Keith Brown (Scottish National Party, Ochil)

Such projects are complex and costly. It is right to take time to get them right. The discussions between Transport Scotland and Network Rail that I mentioned are the right way to go forward and will continue. Those bodies will discuss whether to proceed to guide to railway investment projects stage 3—the option selection stage—and how that is best done.

The situation is frustrating, but substantially more progress has been made in the past four years than in the eight years before them. Substantial further improvements have been made at stations such as Inverurie. We will continue to make progress on that, although we have had to start far later than we would have if the previous Administration had made progress.

Maureen Watt (Scottish National Party, North East Scotland)

While work continues on Kintore station, does the minister agree that the people of the north-east are welcoming today his announcement yesterday that work will start on Inveramsay bridge, for which they have waited for ages? That is happening under the current Government but was delayed under the Lib Dems.

Alex Fergusson (None, Galloway and Upper Nithsdale)

That question has absolutely nothing to do with Kintore station.

Nanette Milne (Conservative, North East Scotland)

My question goes a bit further into the future. It has been brought to my attention by constituents that there would be use in having a branch line from Kintore to Alford—which used to exist—to deliver freight. If the minister is having discussions with Network Rail, will he flag that up so that, if and when Kintore station is finally reopened, that branch line is not blocked for the future?

Keith Brown (Scottish National Party, Ochil)

I apologise for not hearing the initial part of Nanette Milne’s question but, on the latter point, I will certainly take up the matter with Network Rail and get back to her on it.

I note the welcome from Maureen Watt for the work on the Inveramsay bridge, and the fact that that was not welcomed by Mike Rumbles.

Engagements

Iain Gray (Labour, East Lothian)

1. To ask the First Minister what engagements he has planned for the rest of the day. (S3F-2897)

Alex Salmond (Scottish National Party, Gordon)

Later today I will be taking part in a conference call with the directors of Outplay Entertainment, Richard and Douglas Hare, who have announced today that they will be returning home from California to locate their new games company in the city of Dundee, creating 150 new jobs. The entire Parliament will welcome that announcement, which is a significant boost to the games industry in Scotland.

Iain Gray (Labour, East Lothian)

New jobs are always welcome, but we are losing jobs all over Scotland, too. Two months ago, I told the First Minister that the Scottish National Party in Renfrewshire was planning to sack 60 teachers and to replace them with unqualified staff for part of the school week. He had no idea then what his SNP colleagues were up to. He thought that it might be a mistake or a misapprehension on my part. It was not. Renfrewshire Council now plans to implement that proposal in all primary schools in August. Does he support replacing teachers with unqualified staff, and is this the thin end of the wedge?

Alex Salmond (Scottish National Party, Gordon)

As Iain Gray well knows, the proposal is not to replace teachers, but to have various instructors, for physical education and a variety of other areas, come into the school classroom. He will welcome the announced intention of Renfrewshire Council to ask Her Majesty’s Inspectorate of Education to examine the matter and to confirm that it is fully in line with education guidelines.

That will be a lot better than what has happened with North Ayrshire Council, which dominated the headlines at the weekend by apparently trying to introduce a four-day week into Scottish education. Before he criticises Renfrewshire Council, Iain Gray should explain to us what on earth Labour-controlled North Ayrshire Council was doing by trying to introduce a four-day week.

Iain Gray (Labour, East Lothian)

I am glad that the First Minister has brought up North Ayrshire. I know that he has had his spin doctors out, trying to whip up the story. Perhaps he should have checked first. I have with me an e-mail from the leader of North Ayrshire Council, which says:

“I can confirm that we were asked by the SNP Group to bring forward radical options”,

such as a

“4 day week”.

When I heard that, I spoke immediately to the Labour leader of North Ayrshire Council and I got his assurance that that will not happen. He went on radio and television and said that it will not happen. Will the First Minister get on the phone to the SNP leader of Renfrewshire Council and get him to tell us that his plan will not happen either?

Alex Salmond (Scottish National Party, Gordon)

Unfortunately for Iain Gray, I heard the interview with the leader of North Ayrshire Council after his phone call with Iain Gray. He said that he was withdrawing the proposal for a four-day week, and introduced a new proposal to start formal education at the age of six. I have the transcript. The only problem with starting formal education at the age of six—apart from the fact that it would be illegal—is that the phone call that took place between Iain Gray and the council leader needs further explanation. Did Iain Gray say to the leader of North Ayrshire Council that he should withdraw his proposal for a four-day week and instead start education at six? Did he give him an indication that the Labour Party would seek to make it legal not to have education starting below the age of five, or was the phone call a one-way conversation, with Iain Gray refusing to listen to his North Ayrshire leader’s daft ideas? Presumably we can now resolve that North Ayrshire Council ain’t intending to impose a four-day week and ain’t intending to start school at the age of six.

Iain Gray (Labour, East Lothian)

I did not just speak to the leader of North Ayrshire Council about what was happening there, which is not a four-day week. When I asked Alex Salmond about Renfrewshire back in December, he did not know what was going on: he looked frantically through his big book, but he could not find an answer. So I thought that I would go to Paisley and find out what is happening by asking local parents to come and tell me. Five hundred of them turned up, and they told me what Renfrewshire Council is planning. It is planning to take people off the long-term unemployment register, pay them £11 an hour as sessional workers and use them to replace 60 fully qualified teachers. They think that that is an outrage, and they are right. Why will Alex Salmond not call a halt to that crazy plan right now?

Alex Salmond (Scottish National Party, Gordon)

I support Renfrewshire Council’s decision to call in Her Majesty’s independent inspectorate to confirm that what it is doing is in line with teaching regulations.

I will just correct Iain Gray on his claim at First Minister’s questions on 16 December 2010 that Renfrewshire planned

“to replace teachers with volunteers.”—[Official Report, 16 December 2010; c 31698.]

That is not what the General Teaching Council said last week when it made it clear that

“lessons during what is described as the ‘teaching week’ would always be delivered by teachers”.

The GTC went on to say that

“This ... was confirmed in our discussions with Renfrewshire”.

Of course, the Requirements for Teachers (Scotland) Regulations 2005 require that any teacher who is employed by a local authority must be a registered teacher. Teaching must be delivered by registered teachers: that is the position in Scotland—it is the legal position.

Given that Renfrewshire Council is, by calling in Her Majesty’s Inspectorate of Education, conforming with the legal position, I am sure that Iain Gray will reassure us that North Ayrshire Council’s Labour group is not going to proceed with its daft idea to start schooling—illegally—at the age of six.

I know what the position is in Scotland, and I know what the legal position is. I am not sure what the legal position is south of the border, but I note from The Daily Telegraph on 11 January this year that the former Foreign Secretary and Labour leadership hopeful David Miliband announced that he will become an untrained teacher. He will teach A-level government and politics at Haverstock school in Chalk Farm, north London.

Now, if even—[Interruption.]

Alex Fergusson (None, Galloway and Upper Nithsdale)

Order. Order.

Alex Salmond (Scottish National Party, Gordon)

If even David Miliband is trusted to come in and teach A-level students in England, cannot people come in to teach physical education and other aspects outwith the curriculum and be trusted with the children of Renfrewshire, or is David Miliband in a better position than the people who come into the schools in Renfrewshire?

Iain Gray (Labour, East Lothian)

If I was the First Minister of Scotland, and I was asked about what was happening in schools in Renfrewshire for which I am responsible, and I gave an answer that was about David Miliband’s career plans, I would be embarrassed.

As for the GTC, I have the letter that Mr Salmond was reading from, and this is what it says:

“GTC Scotland therefore takes the view”

—it is talking about Renfrewshire’s plans—

“that it would be both professionally inappropriate and potentially illegal”.

He did not read that bit of it out, did he?

As for HMIE, I do not know what it will say, but I know what 500 parents, grandparents and teachers in Renfrewshire told me on Friday.

The First Minister does not always take this line, does he? When Argyll and Bute Council planned to close schools, Mike Russell—who just happens to be the local SNP candidate—ordered SNP councillors to do a U-turn. When I challenged the First Minister on the SNP making 900 council workers redundant in Aberdeen, John Swinney ordered those SNP councillors to do a U-turn. So why will Alex Salmond not tell SNP councillors in Renfrewshire to do a U-turn on this irresponsible scheme? Is it just because he does not have any SNP seats in Renfrewshire that he is worried about?

Alex Salmond (Scottish National Party, Gordon)

No, actually, it is because I trust the independence of Her Majesty’s Inspectorate of Education to look at the proposal and confirm that it is in line with the law. I do not think that we need it to look at the North Ayrshire Council proposal, which is obviously and clearly illegal.

Under Renfrewshire Council’s proposal, every part of the school curriculum will continue to be taught by teachers, but they will not have to remain in the classroom while the extra activities—which are termed “enhancements”—are undertaken. The only change is that the primary teacher will no longer have to sit at the back of the class or the side of the pitch while the sports coach takes the class.

Iain Gray seems puzzled as to the relevance of David Miliband’s attempt to do the same thing in England to the situation in Renfrewshire, Argyll or anywhere else. [Interruption.]

Alex Fergusson (None, Galloway and Upper Nithsdale)

Order.

Alex Salmond (Scottish National Party, Gordon)

I will tell members what the continuing thread is and why Iain Gray did not ask me about Megrahi or the budget today. [Interruption.]

Alex Fergusson (None, Galloway and Upper Nithsdale)

Order, order. First Minister, your microphone is off. I am sorry, but it is entirely up to Mr Gray what he asks about.

Alex Salmond (Scottish National Party, Gordon)

I am pointing out that Iain Gray did not ask about the budget or Megrahi and does not want to hear about David Miliband south of the border because, from top to bottom, the Labour Party in Scotland is an example of organised hypocrisy.

Iain Gray (Labour, East Lothian)

I apologise to the First Minister that I did not ask him the question that he wanted. [Interruption.]

Alex Fergusson (None, Galloway and Upper Nithsdale)

Order.

Iain Gray (Labour, East Lothian)

It is Friday night tomorrow night. I will get those 500 parents in Paisley back. Will the First Minister come with me, look them in the eye and tell them that the council’s proposal is a good idea for their schools?

Alex Salmond (Scottish National Party, Gordon)

I will trust the independent judgment of Her Majesty’s Inspectorate of Education. This Friday, I will be seeking to persuade people in Scotland that 25,000 modern apprenticeships is not only a fantastic deal for young people in this country but the reason why Iain Gray does not want to talk about the budget. The number is 60 per cent more than we inherited from the Labour Party. That is why the budget is good for young people all over Scotland.

Secretary of State for Scotland (Meetings)

Annabel Goldie (Conservative, West of Scotland)

2. To ask the First Minister when he will next meet the Secretary of State for Scotland. (S3F-2898)

Alex Salmond (Scottish National Party, Gordon)

I may well meet the Secretary of State for Scotland this coming Monday.

Annabel Goldie (Conservative, West of Scotland)

The former United Kingdom Secretary of State for Justice, Jack Straw, claims that Kenny MacAskill tried to do a deal linking progress on airguns and slopping out with moves that could have paved the way for Mr al-Megrahi, the Lockerbie bomber, to return to Libya. Did Kenny MacAskill act alone or was the First Minister complicit with him in trying to cut that odious deal?

Alex Salmond (Scottish National Party, Gordon)

Neither. If Annabel Goldie examines the documents from the Cabinet Secretary for Justice, she will see that that dispute is about 2007. In 2007, no one—not even Jack Straw—was attempting to return Mr Megrahi to Libya. The position then was that Jack Straw was trying to persuade the Scottish Government to accept a veto on prisoner transfer, as opposed to the exclusion clause that we wanted.

Testimony to the fact that Jack Straw failed in his attempt to persuade us in that direction are the eight letters from me and the cabinet secretary—four before the meetings in question and four afterwards—which make it clear that the Scottish Government did not at any stage drop its opposition to that proposal or its insistence that there should be an exclusion clause in the prisoner transfer agreement.

When Annabel Goldie takes a closer look at the record and understands the difference between 2007 and 2008 and the changes that occurred in the Labour Government’s policy in that period, she will see that the record clearly vindicates the Scottish Government’s position.

Annabel Goldie (Conservative, West of Scotland)

Let us get this straight: the First Minister is telling us that it was a huge confusion and just a great big muddle. With all the conversations, correspondence, minutes, memos and meetings, he is saying that everyone else has got it wrong. That does not wash.

Let us move on to April 2009, when the First Minister himself asked Jack Straw directly whether he had a view on Mr al-Megrahi being sent back to Libya.

Alex Salmond has always maintained that the release of Mr al-Megrahi was an exclusively Scottish matter and no one else’s business, so why did the Scottish Government give the impression of wanting to cut a deal, and why was Alex Salmond so anxious to find out the UK Government’s view on Mr al-Megrahi being returned to Libya? What on earth was going on?

Alex Salmond (Scottish National Party, Gordon)

We had the American Government’s view and the Libyan Government’s view and submissions and indications from a range of people, but we did not have in public the United Kingdom Government’s view. I say “in public” because the UK Government’s policy changed in October 2008 to facilitate the return of Mr al-Megrahi to Libya, as the cabinet secretary’s papers indicate. That occurred in every level of government and every relevant Government department. I knew that at the time; indeed, I have said a number of times that that was the UK Government’s position. As we now know, there was a change this week, and we have things on the public record. It is extraordinary—even as extraordinary as Richard Baker’s remarkable interview on “Newsnight” on Monday—that the Labour Party in Scotland did not know that that was the United Kingdom Labour Government’s policy.

Annabel Goldie will see two things if she looks at a UK minute of 13 October 2008. Mr Straw was anxious to indicate the implications of Mr Megrahi dying in a Scottish jail. I said three things to Mr Straw: that the matter of the prisoner transfer agreement caused us deep grievance; that nothing that the Scottish Government would ever do or be seen to do would cut across the processes of Scots law; and that a case of compassionate release could be considered as a genuine case only through the due process of Scots law. That is exactly what the Scottish Government has always maintained, and that is why I believe that we have been vindicated by the release of the papers.

On the charge that many people have laid against the Labour Party this week, I gently point out to Annabel Goldie before she claims that the Conservative party as a whole had a consistent position on the matter that both Lord Trefgarne, who is a former Tory minister, and Daniel Kawczynski wrote to the Scottish Government separately. They did not write to say that we should follow the due process of law. Lord Trefgarne said that we should pay attention to commercial interests, and Daniel Kawczynski said that we should use Mr Megrahi as a bargaining chip. The record shows that the Scottish Government has been consistent throughout the affair. We have acted in good faith and followed due process; others have been guilty of organised hypocrisy.

Cabinet (Meetings)

Tavish Scott (Liberal Democrat, Shetland Islands)

3. To ask the First Minister what issues will be discussed at the next meeting of the Cabinet. (S3F-2899)

Alex Salmond (Scottish National Party, Gordon)

Issues of importance to the people of Scotland will be discussed at the next meeting of the Cabinet.

Tavish Scott (Liberal Democrat, Shetland Islands)

The national centre for excellence in traditional music, which is based at Plockton high school, provides many talented children with an opportunity to build a national and, indeed, international career in music. It is surely the embodiment of Scotland’s education system and the curriculum for excellence. It builds young people’s talents and skills and their belief that they are Scotland’s future. The centre opened in 2000 with direct Government funding, which was initially continued in 2007. A year later, Highland Council had to assume complete financial responsibility, and it now faces agonising budget decisions. Will the First Minister consider how best to fund the national centre for all? We all want to secure its future.

Alex Salmond (Scottish National Party, Gordon)

Resources were, of course, transferred to the local government settlement for Highland Council to use. In case there is any misapprehension, there are, of course, Liberal Democrats in the Highland Council administration.

I know that the Cabinet Secretary for Education and Lifelong Learning met John Farquhar Munro, the local MSP, yesterday to discuss the issue. The cabinet secretary assured him of the Government’s determination to ensure that that vital national centre is maintained to help music education across the Highlands. I hope and believe that that enthusiasm will be shared by the Highland Council administration.

Tavish Scott (Liberal Democrat, Shetland Islands)

It is a big step for a 14-year-old to leave home, live in the Plockton school hostel and attend classes in a new place. Young people who make that decision show their commitment to Scotland’s traditional music. The First Minister’s Government is assisting in other local authority areas. For example, travel to the new Burns museum in Ayrshire is being supported by the Government, not just the local council, and Stirling Council, rightly, is not expected to pick up the cost of a makeover of the battle of Bannockburn site.

Does the First Minister therefore accept that the national centre should be funded by the Government, Creative Scotland and the local authorities, such as Highland Council and Shetland Islands Council, that place children at Plockton to further their musical development and careers? Will he ensure that his Government now takes the lead in organising that financial package?

Alex Salmond (Scottish National Party, Gordon)

I repeat that the money was put into the local government settlement. There is an obvious difference between that and the provision for local authorities across Scotland to allow them to ensure that every young Scot will—I hope—at some time in their school days be able to visit the marvellous new Robert Burns museum in Alloway, or the provision for the national resource project involving Historic Scotland and the National Trust for Scotland to ensure that we have a magnificent new visitor centre in time for the 700th anniversary of the battle of Bannockburn in 2014.

In not recognising Highland Council’s responsibilities in the matter, Tavish Scott rather skates over the issue. Occasionally, he should try and take yes for an answer. I was not at yesterday’s meeting between Michael Russell and John Farquhar Munro, but I know that John Farquhar Munro is a passionate advocate of his constituency and the Highlands, and I know that Michael Russell is deeply interested not just in music education, but in giving our children in the Highlands and Islands the maximum opportunities. Although I have not had a read-out on the meeting, I would be very surprised indeed if, between them, those two gentlemen had not made some progress to ensure that Plockton high school can continue to offer its vital educational experience for the children of the Highlands and Islands.

Alex Fergusson (None, Galloway and Upper Nithsdale)

I will take a supplementary from Richard Baker.

Richard Baker (Labour, North East Scotland)

Thank you. I will not dwell on the irony of this First Minister making allegations of hypocrisy.

Alex Fergusson (None, Galloway and Upper Nithsdale)

Mr Baker, at this stage, a supplementary really should just stick to the question.

Richard Baker (Labour, North East Scotland)

Thank you, Presiding Officer.

What support has been given to the victims affected by the dropping of cases as a result of the Cadder judgment? Is the First Minister aware that, a year before the judgment, practitioners in Scotland warned that his Government was in breach of the European convention on human rights on the matter? Does he agree that those events require the Cabinet Secretary for Justice to make an emergency statement to Parliament?

Alex Salmond (Scottish National Party, Gordon)

Where do I start with Mr Richard Baker? I might start with the fact that the highest court in Scotland ruled, by a majority of seven to nil, that Scottish justice was compliant in these matters. I do not know whether Richard Baker is saying that the Lord Advocate should have acted against a ruling of seven Scottish judges in the highest court in our land. When every party in the Parliament supported the emergency legislation that was necessary, it was recognised that the Crown Office and the justice secretary had dealt expeditiously with the extraordinarily difficult position that we had been presented with.

It has been noted today that if the Lord Advocate had not acted immediately when it looked as if the Supreme Court—not the highest court in Scotland, but the United Kingdom’s Supreme Court—was going to deliver an adverse judgment, many thousands more would have been affected. Emergency legislation was passed expeditiously, with the support of Richard Baker.

I am delighted that the Parliament united to pass that emergency legislation. What surprises me is to read today’s comments by Richard Baker attacking the justice secretary, when he, as a member of this Parliament, was prepared to support that legislation to deal with a situation that affected many thousands of our fellow citizens. It is his inability to look at such issues in terms of justice and the rights and expectations of our citizens, and his desperate attempts to gain some petty party advantage in such difficult situations, that have been the mark of Richard Baker throughout the current parliamentary session and why he was reduced to such a confused, rambling wreck on “Newsnight” last Monday.

Schools (Four-day Week)

Kenneth Gibson (Scottish National Party, Cunninghame North)

4. To ask the First Minister what the Scottish Government’s position is on schools being switched to a four-day week. (S3F-2902)

Alex Salmond (Scottish National Party, Gordon)

As has been indicated, the Scottish Government does not support a move to a four-day week in schools. We now know that Iain Gray had to order his councillors in North Ayrshire to fall into line over the phone.

It seems to me that cutting a full day out of the school week, which Labour-controlled North Ayrshire Council seems to have been planning—

Iain Gray (Labour, East Lothian)

The SNP asked for it.

Alex Salmond (Scottish National Party, Gordon)

—would have had a significant impact on pupils, their families and staff, not least of which would have been the difficulties and costs for parents of arranging one day of child care per week. The council has offered no explanation of why it thought that that was a good idea, but given that the Labour council leader quickly dumped the plan after it became public we might have thought that he did not need a desperate phone call from Iain Gray.

Kenneth Gibson (Scottish National Party, Cunninghame North)

A four-day school week has no educational merit whatever. Contrary to the insinuation from Mr Gray, the SNP group was not aware of the Labour proposal before it hit the media—[Interruption.]

Alex Fergusson (None, Galloway and Upper Nithsdale)

Order.

Kenneth Gibson (Scottish National Party, Cunninghame North)

The First Minister is aware that Labour-controlled North Ayrshire Council’s grant will fall by £5.5 million in the year that begins in April. The council said that the cut would be £64 million, which caused widespread consternation among staff and service users. Given that the council’s general services budget will still be more than £340 million and that there is an underspend of £5.4 million, does the First Minister share my concern that, although difficult decisions have to be taken, North Ayrshire Council and other Labour councils are scaring parents, playing politics with children’s education and worrying staff, by overplaying budget reductions for their perceived electoral advantage?

Alex Salmond (Scottish National Party, Gordon)

I got the account of David O’Neill’s interview on BBC Radio Scotland’s “Good Morning Scotland” on 7 February. The Labour leader of North Ayrshire Council confirmed that the council had had a proposal to cut an entire year from school education by increasing the school age to six years old and keeping children in nursery for longer. He does not seem to have divulged in public the information that he divulged to Iain Gray.

There are people who genuinely think that compulsory school education should start at six. It is unfortunate that they would have to look at the Education (Scotland) Act 1980, which says that education must be offered to a person who has

“attained the age of five years and has not attained the age of sixteen years.”

Therefore, although I am relieved that North Ayrshire Labour has been blown off course in its daft plan for a four-day week for Scottish pupils, I am still concerned that a leader of any council in Scotland should advocate the illegal position of school education starting at six. We need more than another phone call from Iain Gray. No wonder he has his head in his hands.

Local Government Expenditure

John Park (Labour, Mid Scotland and Fife)

5. To ask the First Minister what advice the Scottish Government has given to local authorities that are considering reductions in spending regarding services and facilities that should be protected. (S3F-2907)

Alex Salmond (Scottish National Party, Gordon)

As John Park knows, our priorities were to protect 1,000 extra policemen on the streets, the council tax freeze, which has saved families more than £300, free personal care and small class sizes. We did that in agreement with the Convention of Scottish Local Authorities, which took as its main objective the retention of local councils’ share of the public sector cake. COSLA also wanted as much protection for local councils as possible, without denying councils the opportunity to take their own local view on the proposals.

John Park (Labour, Mid Scotland and Fife)

When the First Minister announced the establishment of the Christie commission on the future delivery of public services, he said:

“This Government is determined to ensure these services to which we all hold so dear, continue to be delivered in a manner that keeps the social fabric of Scotland intact.”

I give the First Minister an example in which that has not happened. He might be aware that the outdoor education centre at Ardroy, in Argyll, which is operated by Fife Council, is likely to close, following a decision of the council today. Some 5,000 people have campaigned to keep the facility open and many people expressed concern to me about not just the impending decision but the unacceptable way in which the views of Fife Council employees, in particular, have been suppressed in recent weeks.

It looks like it might be too late for Ardroy, but will the First Minister today send a message to all public service decision makers, to insist that they engage in a meaningful way with all communities as they make the difficult decisions that lie ahead? If decision makers do not do that, there will be no social fabric left at all, let alone any to keep intact.

Alex Salmond (Scottish National Party, Gordon)

The member should bear in mind that local councils must make decisions that are based on the budget and local priorities. I repeat:

“COSLA’s main objective was to retain our share of the public sector cake which we have done. It is doubly pleasing that we have delivered as much protection for our members as possible without boxing councils in and denying them the opportunity to take their own local view on the proposals we have developed with government.”

That is a direct quotation from a press release from Councillor Pat Watters, COSLA president and Labour councillor from North Ayrshire Council—[Interruption.] I should have said South Lanarkshire Council; I admit that Ayrshire has been very much on my mind.

The important point that Pat Watters made is that the settlement for Scottish local government was far better than the settlement for local government south of the border. The outline from Mr Swinney of a flat cash settlement for the next few years is infinitely better than the prospect that councils face south of the border.

I say that to John Park so that he will realise that these are extraordinarily difficult times for public sector finance. Our complaint about Labour members is not that they are worried and aware of the implications at the local council level; it is that they believe that we should all have a collective amnesia about why local government, central Government and every other public service are under such pressure. They are under pressure because of the wrecking of the United Kingdom’s finances and a programme of cuts that are deeper and tougher than those of Margaret Thatcher, which was planned by the Labour Government at Westminster and which is being implemented by the current coalition Government. It is recognition of the fact that the Labour Party is responsible for that situation that we are looking for.

Forestry (Public Ownership)

Jim Hume (Liberal Democrat, South of Scotland)

6. To ask the First Minister what recent discussions the Scottish Government has had with Forestry Commission Scotland regarding the value of forestry under public ownership. (S3F-2911)

Alex Salmond (Scottish National Party, Gordon)

Roseanna Cunningham and Scottish Government officials regularly meet Forestry Commission Scotland to discuss a range of issues. The Scottish Government has made it very clear that, although there may be plans to take forests out of public ownership by the Lib Dem-Conservative Administration at Westminster, the Scottish Government has no such plans. Unlike the Con-Dem Administration, the Scottish Government recognises the enormous economic, social and environmental benefits that our forests and woodlands deliver.

In addition, we have made clear our intention to plant 100 million trees by 2015, which forms a major part of our drive to cut CO2 emissions. We are making excellent progress towards that goal and I am pleased to say that I made a small personal contribution to that when I visited Cochno Hill in November last year.

Jim Hume (Liberal Democrat, South of Scotland)

We are talking about Scottish issues. Everybody knows that it was the Scottish Lib Dems who forced the Scottish National Party Government into a U-turn on its plan to sell off our Scottish forests to the bankers. Since then, the Government has stated that it is against the privatisation of our forest estate. Now, we hear from a Government adviser that Scottish forests are

“being sold piecemeal to the highest bidder.”

There are facts to prove that. Since 2007, there has been a net loss of 26,000 acres of Scottish forest estate, with the Government netting a forest land sales profit of £28 million. Where have those profits gone, and when will the First Minister admit that selling off our forests is still on his agenda?

Alex Salmond (Scottish National Party, Gordon)

The revenue is going to purchase better-value land, which is being planted by the Forestry Commission. The plan is to increase forest cover in Scotland from 17 per cent of the area of our country to 25 per cent. We are on target to have 100 million more trees planted in Scotland over the next few years.

Given the ambition of those plans, I do not think that it is reasonable for a Liberal Democrat member to attack the Scottish Government on our ambitious plans for forestry, especially in the light of the fact that plans may be announced by the coalition Government in England that have direct implications for Scottish jobs in Edinburgh. The fact is that hundreds of jobs in Edinburgh are at risk as a result of the coalition Government’s policies. I do not think that Jim Hume should come to the chamber and say that we cannot talk about what is happening in London given the implications of that for jobs in Edinburgh.

Margo MacDonald (Independent, Lothians)

On a point of order, Presiding Officer. In his answer to John Park, the First Minister admitted that local authorities have full responsibility for policy making in their areas. With the greatest of respect, I question why the leader of the Opposition and the First Minister were allowed to hurl insults at each other about what local authorities should or should not do. I ask you to call together the leaders of the parties and remind them of the standing orders.

Alex Fergusson (None, Galloway and Upper Nithsdale)

That is not a point of order for me, and whom I decide to meet is a matter entirely for me.

I suspend the meeting until 14:15.

12:34 Meeting suspended until 14:00.

14:00 On resuming—

Huntington’s Disease

Kenneth Macintosh (Labour, Eastwood)

1. To ask the Scottish Executive what action it is taking to improve equity of access to health care for people with Huntington’s disease. (S3O-12977)

Shona Robison (Scottish National Party, Dundee East)

We are encouraging implementation of NHS Quality Improvement Scotland’s clinical standards for neurological health services. That will help to improve access to services for those with neurological conditions such as Huntington’s disease, wherever in Scotland they live.

Kenneth Macintosh (Labour, Eastwood)

I am sure that the minister will be aware of how much patients rely on the support and care of specialist nurses. Is she aware that specialist nurses are available in the Greater Glasgow and Clyde NHS Board area, but only to residents of Glasgow City Council, so patients with Huntington’s disease in, for example, East Renfrewshire cannot access that specialist nurse provision?

Shona Robison (Scottish National Party, Dundee East)

I am aware that there are specialist nurses in eight NHS boards. Obviously, we would encourage more specialist nurses to be recruited, particularly given that we know that they are good value for money, and we encourage boards to do that. Also, it is fair to say that the progress that we believe will be made through the investment in the neurological managed clinical networks—which we have given money to each board to develop—will make a real difference to patient care.

I am certainly willing to have a look at the specific issue that the member raised. I am sure that there are good reasons for that related to the local arrangements, but I am willing to have a look at the issue in more detail and I will write to the member.

Support for Carers (Remote Areas)

Jamie Stone (Liberal Democrat, Caithness, Sutherland and Easter Ross)

2. To ask the Scottish Executive how the back-up and support for carers in Scotland’s remotest areas will be safeguarded during times of reduced Government spending. (S3O-13005)

Shona Robison (Scottish National Party, Dundee East)

Scottish Government spending on support to carers has not reduced. With the approval of the budget, members will be pleased to note that the £1 million that we allocated for 2010-11 for short breaks will now be rolled forward to 2015, making £5 million in total over that period. Now that the budget has been approved, there is £5 million for the carer information strategies in 2011-12, and both of those programmes support carers in remote and rural areas.

Jamie Stone (Liberal Democrat, Caithness, Sutherland and Easter Ross)

I thank Shona Robison for her answer—indeed, I welcome it. One of the problems that we have in my constituency is that if a patient from north-west Sutherland has to go to Raigmore hospital in Inverness for an appointment, the carer who is accompanying the patient—and, of course, the patient himself or herself—has a round trip that may last the whole day. Trying to find the time for that puts the carer in a pretty impossible position, and the Scottish Ambulance Service is not able to offer a huge amount of help. We have money in the budget, so how can the minister help carers who are placed in that situation?

Shona Robison (Scottish National Party, Dundee East)

When they are considering how to spend their share of the £5 million for carer information strategies, we would expect health boards to consider local need. They should be discussing with local carers and carer organisations the priorities for spending the money. I suggest that Jamie Stone raise that point with the health board as a possible way forward.

Rob Gibson (Scottish National Party, Highlands and Islands)

I hear the minister’s answer, and I wonder whether she can help us with the detail of the joint community care plan that Highland Council and Highland NHS Board have set up, which includes carer centre and carer advocacy tenders. Will those help some of the remoter communities, as mentioned in the original question? Is that the way forward to find new money?

Shona Robison (Scottish National Party, Dundee East)

I believe that it certainly is, and I will be happy to write to the member with more detail of the plan and how I see it being taken forward.

Alex Fergusson (None, Galloway and Upper Nithsdale)

Question 3 is from Dr Richard Simpson—[Interruption.]. He is not here, I am afraid to say.

National Health Service Dental Services (North-east)

Nigel Don (Scottish National Party, North East Scotland)

4. To ask the Scottish Government what steps it has taken to increase the number of people registered with an NHS dentist in the north-east. (S3O-12929)

Shona Robison (Scottish National Party, Dundee East)

The Scottish Government, through a series of measures, has taken significant steps to increase the number of people registered with an NHS dentist in the north-east. From June 2007 to June 2010, patient registrations have increased by 146,992 in NHS Grampian and NHS Tayside.

Nigel Don (Scottish National Party, North East Scotland)

What steps is the Government taking to increase registrations and access to dentists in rural communities?

Shona Robison (Scottish National Party, Dundee East)

This is a very important issue, and we have been trying to focus in particular on areas where there are still access issues. Indeed, we have been very successful in that respect, although I know that the area that Nigel Don represents still faces some challenges. We have the remote areas allowance, which provides up to £9,000 for independent and salaried dentists who are classed as remote, and we are also encouraging dentists to locate in towns such as Montrose. Indeed, the health board has been very effective in encouraging dentists to set up in areas where people might still require access to an NHS dentist. The member should perhaps contact the health board to get a bit more detail on the future plans for that particular area.

Nanette Milne (Conservative, North East Scotland)

Many NHS dentists left the service a few years back. Are there any records showing how many have come back into the service?

Shona Robison (Scottish National Party, Dundee East)

The number of dentists coming into the NHS has increased over the past two or three years and I find it very encouraging that so many dentists see the NHS as their future in their profession. Five years ago, there was a feeling that dentists were drifting out of the NHS, and the change in that situation is down to the significant investment that has been made in NHS dental services. The NHS can make dentists a good offer. Although I do not have specific figures on the number of dentists who left and then have come back into the NHS, the increase that I referred to is likely to be a mix of those dentists and, of course, new dentists coming out of our dental schools and wanting to work in the NHS in Scotland.

Dave Thompson (Scottish National Party, Highlands and Islands)

New dental surgeries have been planned in Portree for some time now. I believe that the land acquisition process is nearly complete, but what further progress is expected to be made this year?

Shona Robison (Scottish National Party, Dundee East)

We are expecting significant progress this year. Of course as the member will be aware, and as I have said in response to previous questions, despite our efforts, the recruitment of dentists and the increase in registrations across Scotland, we have still faced a challenge in Portree. That is why it was right and proper to identify the area for investment through the primary care fund, and we certainly expect major progress to be made this year. I am very happy to provide the member with more detail of that plan.

Adult Community Care

Charlie Gordon (Labour, Glasgow Cathcart)

5. To ask the Scottish Executive what discussions it has had with local authorities, carers and service users regarding its proposed changes to adult community care. (S3O-12967)