Scottish Parliament, 14 March 2018

98 contributions from 30 members. The official report.

Health and Sport

Linda Fabiani (Scottish National Party, East Kilbride)

The next item of business is portfolio questions on health and sport. It would be good to get as many people in as possible, so please bear that in mind.

NHS Grampian (Waiting Times)

Peter Chapman (Conservative, North East Scotland)

1. To ask the Scottish Government what action it is taking to support NHS Grampian and reduce the board’s waiting times. (S5O-01887)

Shona Robison (Scottish National Party, Dundee City East)

NHS Grampian is using the £4.9 million from the £50 million that we made available to boards in the current financial year to address long waits across the whole patient pathway, in specialties including orthopaedics and ophthalmology.

NHS Grampian has received £470,000 of the £4.85 million cancer funding that has been released in 2017-18. That funding has been provided to ensure that cancer patients continue to be prioritised and treated within the expected waiting times, wherever that is clinically possible. That revenue is being targeted to increase scope and diagnostic and imaging capacity.

Peter Chapman (Conservative, North East Scotland)

For the past nine months, NHS Grampian has had the worst waiting times in Scotland. In that time, more than 18,000 people have waited more than 18 weeks for treatment. Core revenue expenditure for NHS Grampian is the second lowest in Scotland, with spend per head of only £1,671. Does the cabinet secretary admit that that is unacceptable, and will she apologise to the people of Grampian?

Shona Robison (Scottish National Party, Dundee City East)

In 2018-19, NHS Grampian’s resource budget will be £920.6 million. That is an uplift of 2.1 per cent on the budget for 2017-18, which is the highest uplift for any territorial national health service board.

The situation would be worse if we had applied the Tory tax plans, which would have taken £49.5 million out of Grampian’s resource budget. It really does not hold up for Maurice Corry to come here complaining about NHS Grampian’s resource budget when he would have taken almost £50 million out of it, had his plans gone ahead.

Liam McArthur (Liberal Democrat, Orkney Islands)

As the cabinet secretary will be aware, the waiting times affect not only people in the NHS Grampian region, but people who are covered by the island health boards, including people in Orkney.

Can the cabinet secretary update Parliament on what discussions she or her officials have had with NHS Orkney about the additional investment that is going into NHS Grampian and how it meets the needs of island patients from Orkney and Shetland?

Shona Robison (Scottish National Party, Dundee City East)

Liam McArthur will be aware that the involvement of NHS Orkney and NHS Shetland in the discussions is very important. As he knows very well, many of his constituents rely on the services of NHS Grampian for procedures that cannot be carried out on the islands. NHS

Orkney and NHS Shetland will have received their share of the £50 million waiting times initiative funding, as NHS Grampian has.

I expect—I know that this is happening very much in the north of Scotland—boards to work together and maximise collaboration in order to ensure that they can shorten the patient journey and share resources. I also expect that where there are, for example, shortages of particular specialist staff, they will look for north-wide solutions in trying to recruit them. That work has been led very well by Malcolm Wright. I am very happy to write to Liam McArthur with more detail, if he would find that helpful.

Richard Lochhead (Scottish National Party, Moray)

Although I welcome the extra cash for NHS Grampian, I draw the cabinet secretary’s attention to the growing frustration that is being expressed by the campaign group called Affa Sair on the long waiting times for pain clinics, particularly in Moray, given that people do not want to have to travel to Aberdeen all the time for treatment. Can she investigate that matter and perhaps provide an update to me and Affa Sair directly?

One member of the campaign group, Brenda Carnegie, was quoted in

The Press and Journal

this week—

The Deputy Presiding Officer

You must come to a close, please.

Richard Lochhead (Scottish National Party, Moray)

One member of the group was quoted

as saying that she had waited more than two years for injections that she should get every six months. Could the cabinet secretary investigate that issue as well, please?

Shona Robison (Scottish National Party, Dundee City East)

I will be happy to do that and to get back to the member. Nationally, almost three quarters of patients who had been referred to a pain clinic were seen within the 18-week standard, which is a significant increase on the previous quarter. However, there was, of course, too much local variation across boards, which we want to eradicate. I can assure Richard Lochhead that the Government is very committed to ensuring that all patients, no matter where they live, have swift access to the full range of services that they need.

I am aware that waiting times in NHS Grampian are longer than we expect. In the past year, it has had significant staff absences that have affected waiting times. Recent recruitment has been successful, which has enabled additional clinics to be offered, but I will be happy to look into Richard Lochhead’s query about pain clinics in Moray and get back to him.

The Deputy Presiding Officer

We have a supplementary question from Lewis Macdonald.

Lewis Macdonald (Labour, North East Scotland)

Early diagnosis can make the difference between successful and unsuccessful treatment of diseases such as cancer. Given the importance of that and of early investigation—on which, I know, the cabinet secretary will agree with Cancer Research UK—will the cabinet secretary tell us what specific steps she will take to reduce waiting times for diagnosis and investigation for patients with such diseases in Grampian?

Shona Robison (Scottish National Party, Dundee City East)

Lewis Macdonald will be aware of the work that is being done by the cancer strategy on improving cancer services across Scotland. As I said in my initial answer, NHS Grampian has received £470,000 of the £4.85 million cancer funding that was released last year. The focus of that money has very much been on increasing scope and diagnostic and imaging capacity, which will continue to be our focus.

We know that once a person is diagnosed, their journey to treatment is very short, so it is the diagnostic pathway that we need to shorten. Lewis Macdonald might be aware that I chair a national group of the very best experts in the field, who are looking at best practice. There is still variation in the diagnostic pathway, so we are seeking to ensure that we do everything possible to shorten it. I will be happy to keep the member apprised of any details.

Neonatal Expenses Fund

Mark Griffin (Labour, Central Scotland)

2. To ask the Scottish Government when details of the fund to support parents of premature babies in hospitals will be announced. (S5O-01888)

Shona Robison (Scottish National Party, Dundee City East)

We are pleased to announce that the neonatal expenses fund will go live on 1 April, and will be available to families of all babies in neonatal care. We have worked with NHS boards and the neonatal charity Bliss to develop a clear and simple scheme that is universally accessible, and we have written to all boards this week to outline the details. I also put on record Mark Griffin’s active pursuit of the issue, which is well understood and very welcome.

Mark Griffin (Labour, Central Scotland)

I thank the cabinet secretary for her answer and for the work that has gone into setting up the fund. I am delighted to say that it will start on my daughter Rosa’s first birthday. I ask the cabinet secretary what levels of support the fund will provide each day, and whether there will be daily limits. The cabinet secretary will be aware that babies will be born before 1 April who will still be in hospital after that date. Will she give an assurance that parents of those babies will be able to access the fund? How will use of the fund be tracked throughout the financial year, and what provisions are in place should the fund become exhausted within that year?

Shona Robison (Scottish National Party, Dundee City East)

I cannot think of anything more appropriate than the fund being launched on baby Rosa’s birthday.

The fund will support parents with the costs of travel, parking and meals. I can tell Mark Griffin that we will make it very easy for people to claim. A leaflet and a copy of the claim form will be given to a family when their baby is admitted to a neonatal unit. In addition, posters will advertise the scheme to ensure that people are aware of it.

It is also important that we review and monitor the scheme to see whether adjustments are required, so we will review it after six months and at the end of the first year in order to evaluate the provision. We can consider whether any changes to the scheme are necessary and we will, of course, want to hear from parents who use it.

On babies who are born prior to 1 April, I will write to Mark Griffin with that information, because I want to give accurate information. I will, going forward, be happy to keep the member informed of the details, given his active interest.

Fulton MacGregor (Scottish National Party, Coatbridge and Chryston)

What engagement has the Scottish Government had with the UK Government regarding the extension of maternity leave and statutory maternity pay for parents of premature or sick babies? I remind Parliament that I am the parliamentary liaison officer to the cabinet secretary.

Shona Robison (Scottish National Party, Dundee City East)

Fulton McGregor raises an important point about additional support that families in such situations would no doubt welcome. I am aware that in September last year, at the request of Margot James—the then Parliamentary Under Secretary of State at the Department for Business, Energy and Industrial Strategy—the Advisory, Conciliation and Arbitration Service published new guidance for employers to help them to support staff who have given birth to premature or very sick babies. I certainly welcome that move to provide information to parents on their rights and to employers on how best to support parents, and I hope that it will have positive results for parents. The Scottish Government supports the proposal, which I believe has also been suggested by the neonatal charity, Bliss. We will work with colleagues who have responsibility for childcare and the early years and for social security to ensure that we keep pressure on the United Kingdom Government to do its bit.

Miles Briggs (Conservative, Lothian)

I start by paying tribute to Mark Griffin for helping to secure the £1.5 million fund for parents of premature babies.

Alongside the fund, the health secretary announced in December that she was working with health boards to ensure sufficient and free accommodation for all parents whose premature babies are in hospital. Can she update Parliament on the progress that has been made on that front?

Shona Robison (Scottish National Party, Dundee City East)

All boards have some provision for accommodation where there is a need for a family to stay. Four out of the 15 units currently offer accommodation for parents in their unit, and 11 others offer accommodation elsewhere in the hospital. We continue to work with boards to ensure that there is sufficient free-of-charge accommodation available to all parents who need it. Progress is being made, but there is still progress to be made.

Pollution

Mark Ruskell (Green, Mid Scotland and Fife)

3. To ask the Scottish Government what analysis the health secretary has made of the potential implications for Scotland of the findings in the recent annual report of the Chief Medical Officer for England, which addressed the impact on public health of pollution. (S5O-01889)

Aileen Campbell (Scottish National Party, Clydesdale)

We welcome the broad-ranging and thorough report from the chief medical officer for England. Work by the Scottish Government, our partners and stakeholders to deliver environmental protection and improvement is supported by Scotland-specific advice from the chief medical officer for Scotland and from Health Protection Scotland. Many of the issues that are identified in the report have relevance for Scotland, and Health Protection Scotland will consider the findings in detail to add to the evidence base that is directing the work that is taking place—for example, through cleaner air for Scotland—to reduce the burden of disease from pollution in this country.

Mark Ruskell (Green, Mid Scotland and Fife)

One of the main findings of the report is that we simply do not know the combined effects of different forms of pollutants such as noise, light and air and the impact that those can have on health inequalities. Such issues greatly concern my constituents who live in the shadow of the Mossmorran plant in Fife. Will the minister support calls for a long-term health study of the combination effects of those different forms of pollutants around the Mossmorran site?

Aileen Campbell (Scottish National Party, Clydesdale)

We recognise that the chief medical officer for England’s report was wide ranging and that it identified a number of the issues that Mark Ruskell has mentioned, including noise, light and air pollution. Work is currently being carried out on a number of those issues in Scotland, and I will be happy to take into account any concerns that his constituents may have. I am also happy to meet Mark Ruskell if that would help and if he wants to elaborate further on some of the specific concerns that his constituents have. He raised the three issues of noise, light and air pollution. Work is taking place across all those issues, and we will continue to make improvements where we need to.

David Stewart (Labour, Highlands and Islands)

The minister will be well aware that air pollution from particulate matter is responsible for 2,000 early deaths in Scotland each year and that exposure to nitrogen dioxide in PM2.5

causes 2,500 premature deaths each year according to the Royal College of Physicians.

Does the minister share my view that those who are least responsible for air pollution are the worst affected and that they are the most vulnerable in our society? Does he also share my view that the action that is required includes the urgent roll-out of low-emission zones, additional funding for active travel and bus regulation?

Aileen Campbell (Scottish National Party, Clydesdale)

As David Stewart knows, the Government is taking a number of actions on a range of the issues that he outlines. We are, as a country, meeting both domestic and European air quality targets across much of Scotland, but we understand and recognise that there are hotspots of poorer air quality in a number of urban areas. The member is right to identify the inequality that is linked to some of the people who are most impacted by that.

We have set more stringent air quality targets than the rest of the UK. Scotland is the first country in Europe to legislate for particulate matter—a pollutant that is of special concern for human health. We also have money and resources for the efforts that we want to make, not least for the low-emission zones that the cabinet secretary announced fairly recently.

We are making progress in a number of areas in recognition of the fact that the issue has an impact on people’s quality of life, and we need to endeavour, across portfolios, to alleviate that impact as best we can.

The Deputy Presiding Officer

I ask members to be a bit more succinct with their questions and ministers to be a bit more succinct with their answers, so that more members can get in with supplementary questions.

Healthier, Wealthier Children

Alison Johnstone (Green, Lothian)

4. To ask the Scottish Government what progress it has made rolling out the healthier, wealthier children approach to income maximisation across Scotland. (S5O-01890)

Aileen Campbell (Scottish National Party, Clydesdale)

The

Scottish Government remains committed to embedding across all the national health service boards the key principles of the healthier, wealthier children’s approach of health and advice services joining up to ensure that pregnant women and families have access to financial advice when they need it. To progress that, we asked NHS Health Scotland to carry out a scoping exercise—which ran between March and October last year—with all NHS boards to establish their current position on the embedding of health and advice service referral pathways.

The scoping exercise showed that, although a number of boards have formalised referral pathways, some are at an earlier stage in their journey. NHS Health Scotland has established a short-life sub-group of Scotland’s health promotion managers group to make recommendations to the Scottish Government on the next steps to ensure that all boards establish pathways. We expect to receive those recommendations in April, and we will consider them carefully to inform our next steps.

Alison Johnstone (Green, Lothian)

Our research suggests that, based on the success of

the healthier, wealthier children programme in 2012, rolling out the programme across Scotland would lead to gains of at least £9.4 million for pregnant women and families in the greatest need. The evidence that we have clearly suggests that the programme helps to improve health and reduce inequalities. The minister has made the point very clearly that—

The Deputy Presiding Officer

Can you reach the question, please, Ms Johnstone?

Alison Johnstone (Green, Lothian)

The minister has made the point very clearly that referral pathways are key. Will the minister be specific about what additional resourcing will be provided to deliver those pledges? How much cash will the Government use to fund the roll-out?

Aileen Campbell (Scottish National Party, Clydesdale)

The analysis that Alison Johnstone outlines shows the compelling need to make sure that this can happen. That is why it is important to understand the situation across the country. The child poverty delivery plan will be essential in progressing the healthier, wealthier children programme, as it

will provide resources to progress that important programme. I am not in a position to outline the exact funding that will be provided, but we will endeavour to keep the member up to date. She is right to articulate that, by spending a little, we can potentially save many people and many families a lot and help to reduce inequalities.

Health Inequalities

Rachael Hamilton (Conservative, Ettrick, Roxburgh and Berwickshire)

5. To ask the Scottish Government what action it is taking to tackle health inequalities, and what role having access to arts and culture can play in this. (S5O-01891)

Aileen Campbell (Scottish National Party, Clydesdale)

One of the biggest challenges that we face is in reducing health inequalities, which

are a symptom of wider social inequalities. That is why we are focusing on the underlying causes that drive health inequalities. We are focusing on ending poverty, ensuring fair wages, supporting families and improving our physical and social environments.

The Scottish Government is working in collaboration with individuals, communities and organisations across Scotland to develop a culture strategy that will set out a vision and priorities for the future development of culture in Scotland, enabling everyone to have the opportunity to take part in or contribute to cultural life in Scotland.

We know that people who engage with and participate in cultural activities report better health outcomes. We are, therefore, seeking to better embed arts and culture into health and care settings, and many organisations that work in the arts, such as the Scottish Mental Health Arts Festival, are recognising the health benefits that they can bring to their audiences.

Rachael Hamilton (Conservative, Ettrick, Roxburgh and Berwickshire)

Aileen Campbell is correct in saying that the Scottish Government found that participation in culture has significant links with good health and high levels of life satisfaction. In fact, Fiona Hyslop, the Cabinet Secretary for Culture, Tourism and External Affairs, said:

“Starting young, and being encouraged to take part in culture as a child, makes it more likely that the benefits of taking part will be experienced as an adult.”

Does the minister agree that recent decisions concerning the Scottish Youth Theatre and other services have the potential to damage the nation’s health? Does she agree that more needs to be done to increase access, especially for young people, to arts and culture throughout Scotland to improve health outcomes?

Aileen Campbell (Scottish National Party, Clydesdale)

I concur with the sentiment expressed by the cabinet secretary that, if we enable young people to participate in the arts and culture, they are more likely to be able to enjoy them in later life. The same goes, perhaps, for sport. That is why we have endeavoured to offset the cuts from the UK national lottery, which have threatened many of our cultural and sporting organisations that enable young people to participate in the arts and culture. I recognise, too, the on-going and topical issue of the Scottish Youth Theatre. I understand that discussions on that decision are continuing, so that that much-loved and well-respected organisation will have some sort of sustainable future.

Elaine Smith (Labour, Central Scotland)

Given that the minister seems aware that health inequalities, including inequalities in mental health, are often a symptom of poverty, will she commit the Government to addressing the shortfall in funding for other community projects that give more deprived communities an opportunity to engage in the arts and cultural activities?

Aileen Campbell (Scottish National Party, Clydesdale)

Again, I imagine that my colleague Fiona Hyslop would have more to say about that, and I will certainly direct the request for the information that Elaine Smith seeks to the culture department.

As I said in my response to Rachael Hamilton, in order to protect some of our cultural organisations, we have offset the cuts experienced from the UK national lottery, which have threatened many of the organisations that rely on that revenue source—that is the same story that we experienced in sport. It was important that the Scottish Government stepped in to offset those reductions.

As I said in my original answer, we want to reduce and reverse inequality, and we want to make sure that many young people get the opportunity to participate in arts and culture. That is why it is important that we continue to press the national lottery for an adequate strategy to reduce the fall in revenues.

Foetal Alcohol Syndrome

Rona Mackay (Scottish National Party, Strathkelvin and Bearsden)

6. To ask the Scottish Government how the NHS monitors children diagnosed with foetal alcohol syndrome. (S5O-01892)

Aileen Campbell (Scottish National Party, Clydesdale)

The Scottish Government funds NHS Scotland to provide a range of services to promote and protect the health of children. Hospital, general practice and nursing services provide on-going healthcare to children diagnosed with long-term medical conditions such as foetal alcohol syndrome. In July

2017, we launched the foetal alcohol spectrum disorder care pathway, which is an e-learning resource for health professionals that aims to help with the diagnosis of the condition and to support the families and carers of affected children.

Rona Mackay (Scottish National Party, Strathkelvin and Bearsden)

In Scotland, we have benefited from the support needs system, which allows the recording of children with diverse types of health needs, including those resulting from foetal alcohol syndrome. That system is currently being reviewed. Does the minister agree that it is important to have an interconnected system throughout Scotland? Will the review consider our having a single data recording system instead of one that is fragmented into health board areas?

Aileen Campbell (Scottish National Party, Clydesdale)

Rona Mackay is absolutely right to point to the fact that we need consistency in how we diagnose and record the incidence of foetal alcohol syndrome. The health boards record diagnoses of conditions on their local information systems, and the FASD care pathway, which we launched last July, provides all health professionals with the necessary information to help with the diagnostic and support process. There is also a multidisciplinary professional Scottish intercollegiate guidelines network group looking specifically at the assessment and diagnosis of foetal alcohol syndrome. That group is due to report by the end of this year, and we will certainly ensure that the points and issues raised by Rona Mackay on the consistency of diagnosis are part of that work.

The Deputy Presiding Officer

Brian Whittle has a quick supplementary question.

Brian Whittle (Conservative, South Scotland)

I ask this question on behalf of a constituent who wants to know,

from a social care intervention and child protection perspective

,

what the process is following the birth of children with foetal alcohol syndrome and those experiencing the effects of opiates.

Aileen Campbell (Scottish National Party, Clydesdale)

The prevalence of foetal alcohol syndrome is complex and there is no single treatment for foetal alcohol spectrum disorder, which varies in its presentation and severity although it is recognised as a lifelong condition.

There is evidence that early intervention support to enhance learning and manage self-regulation and behaviour can be beneficial. That involves early enrolment with relevant educational resources and other agencies such as social and psychological services. Enhanced awareness and recognition of FASD and adopting the getting it right for every child approach to support families can optimise the long-term management of FASD. If the member would like to write to me about the specifics of his constituent, I would be happy to take the matter further.

Clinical Review of Cancer Access Standards

Maurice Corry (Conservative, West Scotland)

7. To ask the Scottish Government what progress it is making with the clinical review of cancer waiting times, and when the results will be published. (S5O-01893)

Shona Robison (Scottish National Party, Dundee City East)

The clinical review of cancer access standards in Scotland provides an excellent opportunity to examine how information on cancer waiting times could be best used to modify and enhance the patient experience. It will determine whether any amendments or modifications are required to ensure that the cancer waiting times standards best meet the needs of patients and the national health service for the future.

A wide range of views from stakeholders, including patients, the public, primary and secondary care clinicians, data staff and third sector organisations have been collated to help to formulate the review recommendations. They are being finalised with a view to publication in the spring of this year.

Maurice Corry (Conservative, West Scotland)

Is the cabinet secretary able to describe what actions are being considered as part of the clinical review of cancer waiting times targets to minimise inequalities of service across the health boards and to ensure that those missing the target are given the support needed to improve performance? Will the review look at the areas that have been suggested by Cancer Research UK?

Shona Robison (Scottish National Party, Dundee City East)

The review is first about making sure that our targets are fit for purpose and then looking at what adjustments, if any, need to be made. There is broad clinical agreement that the existing 62-day and 31-day standards have been crucial in driving up performance and patient care, although there is still some improvement to be made.

It is also about looking at things such as pathway complexity and making sure that that is understood. For some cancers, that pathway is more complex and the targets need to be appropriate in those circumstances. Whether some of those cancer types should be within the targets should be considered because, as the member will be aware, not all are.

I do not want to prejudge what the recommendations will be, but the right people are looking at this and I am confident that they will help us to make the improvements, whatever they are, that will ensure that our cancer services are fit for purpose for the future.

Ambulance Waiting Times

Jackie Baillie (Labour, Dumbarton)

8. To ask the Scottish Government what action it is taking to reduce ambulance waiting times. (S5O-01894)

Shona Robison (Scottish National Party, Dundee City East)

The Scottish Ambulance Service is undertaking a number of measures to look at ways in which it can improve response times to calls from patients and healthcare professionals who request an ambulance. It is also looking to improve pathways for patients to ensure that they receive the most appropriate clinical response to meet their needs. The service is committed to ensuring that it continues to deliver a high-quality level of emergency healthcare to the people of Scotland, and the Scottish Government continues to support the service as it takes forwards that work.

Jackie Baillie (Labour, Dumbarton)

My constituent Elizabeth Clayton is 100 years old, registered blind, and lives in Renton, which is minutes away from the Vale of Leven hospital. She became ill at 2 pm and her doctor called for an ambulance to take her to the Vale. No ambulance appeared despite phone calls from the family, and at 10 pm that same day, the call was upgraded to a 999 emergency. The ambulance eventually arrived at 1 am, 11 hours after it was first called.

Will the cabinet secretary apologise to Mrs Clayton, who waited for 11 hours in considerable pain? What action will she take to support our dedicated paramedics by increasing the capacity of our ambulance service?

Shona Robison (Scottish National Party, Dundee City East)

In such a case, I expect the Scottish Ambulance Service to be investigating. If Jackie Baillie has not already passed the case on to the Scottish Ambulance Service, she should. I also want to see the details and, of course, I would apologise to Mrs Clayton.

I would also want to know the context of when this happened. Jackie Baillie will be aware of some of the challenges that the Scottish Ambulance Service has faced during the winter but, for Mrs Clayton, that is no consolation. I would therefore want to look into the details of that case as soon as possible.

Jackie Baillie will be aware that we have increased the funding to the Scottish Ambulance Service to strengthen the workforce, with the recruitment of a further 224 paramedics this year, which is in line with the commitment to see 1,000 more paramedics recruited by the end of 2021. She will also be aware that, in addition to the response in emergency vehicles, a lot of training of community paramedics goes on. They will be able to see and treat people within their own homes, where that is appropriate. If Jackie Baillie can furnish me with details of the case, I will make sure that it is fully investigated.

NHS Grampian (Funding)

Mike Rumbles (Liberal Democrat, North East Scotland)

9. To ask the Scottish Government, in light of information provided by the Scottish Parliament information centre suggesting that NHS Grampian has been underfunded by £165.6 million since 2008, whether it plans to provide additional funding to meet that long-term shortfall. (S5O-01895)

Shona Robison (Scottish National Party, Dundee City East)

I will repeat the response that I provided to Mike Rumbles in this chamber on 24 January. NHS Grampian will receive a resource budget uplift of 2.1 per cent in 2018-19, which is the highest percentage uplift of any territorial board. That includes a £5 million share of additional NHS Scotland resource allocation committee parity funding and takes the board’s annual resource budget to £921 million.

Over a seven-year period, the Scottish Government has invested an additional £1.2 billion in supporting those boards that are below their NRAC parity levels. In 2018-19, all boards will be within 0.8 per cent of NRAC parity, and that will be the first time that that has been the case.

Mike Rumbles (Liberal Democrat, North East Scotland)

The minister will be aware of the shocking report that was published yesterday, which highlighted that more than a quarter of patients who suffer chronic pain disorders have been forced to wait longer than 18 weeks for treatment. Once again, NHS Grampian has the worst results for Scotland, with 542 people waiting desperately as the deadline for treatment has come and gone. Does the minister now agree that 10 years of underfunding have left NHS Grampian unable to deliver the same level service as is received by patients in the rest of Scotland? Just repeating an answer from January does not help.

Shona Robison (Scottish National Party, Dundee City East)

The answer from January is factually correct. I repeated it because facts matter. NHS Grampian has received the highest percentage uplift of any territorial board and it is within 0.8 per cent of NRAC parity.

Earlier, I said that the chronic pain waiting times had significantly improved from last quarter to this quarter, but there was local variation. That local variation is for those both above and below NRAC parity. If we look at NHS Ayrshire and Arran, for example, we see that it has work to do as well. It is not correct to link the variation to the issue of NRAC parity.

What NHS Grampian needs to do, and is doing, is recruit the staff that it needs to provide the clinics. If Mike Rumbles had listened to my earlier answer he would have heard me say that NHS Grampian has had difficulties with recruiting people to staff the clinics. It has been on a recruitment campaign and has had some success with that, but it is not a money issue—it is about the ability to recruit staff. Perhaps if Mike Rumbles met people from NHS Grampian more often, he might get the detail that he requires.

Health Inequalities

Andy Wightman (Green, Lothian)

10. To ask the Scottish Government what discussions the health secretary has had with the housing minister regarding action that can be taken to mitigate the cost of health inequalities brought about by poor or unsuitable housing. (S5O-01896)

Aileen Campbell (Scottish National Party, Clydesdale)

Ministers and officials have discussions on a wide range of issues aimed at tackling health and social inequality. I have met the Minister for Local Government and Housing regarding ways that we can collaboratively create a fairer and healthier Scotland.

For instance, the new fuel poverty strategy and the warm homes bill will contribute to a number of Government objectives and help to improve outcomes across Scotland. The Government’s overarching ambition is to see a Scotland where everyone lives in a warm home, has sufficient income for healthy living, has access to affordable, low carbon energy, and has the skills to make appropriate use of energy.

Andy Wightman (Green, Lothian)

Year-on-year increases in housing costs mean that, for many people, housing affordability remains a key driver of inequalities, particularly in areas where there is a chronic shortage of affordable housing. We know that the national health service would be able to achieve around £60 million a year in preventative savings if investments were made in affordable housing, but does the minister agree that in comparison with England and Wales we have inadequate data on the effectiveness of investment in housing to improve health, and does she also agree that housing is a key health intervention for many people?

Aileen Campbell (Scottish National Party, Clydesdale)

Absolutely. The reason why I continue to work with my colleague Kevin Stewart is the real impact that good-quality housing has on health outcomes and reducing health and social inequalities. That is why the Government has invested considerably in housing. Over the previous parliamentary session, more than 33,000 affordable homes were delivered, of which more than 22,000 were for social rent. The ambitions continue, with more money being put in to ensure that we achieve our desire to reach 50,000 affordable homes over the lifetime of the current session of Parliament, through a 76 per cent increase on our previous five-year investment. The Government gives incredible importance to housing, because of the allied health benefits and associated ways in which it can help us to tackle inequality. I am happy to engage with the member further, but I know that Kevin Stewart, the Government and I remain committed to ensuring that we can create a healthier and fairer Scotland by continuing to meet the ambitious targets that we have set and that are being delivered on.

NHS Greater Glasgow and Clyde (Meetings)

Jackson Carlaw (Conservative, Eastwood)

11. To ask the Scottish Government when the Cabinet Secretary for Health and Sport last met the chief executive of NHS Greater Glasgow and Clyde, and what issues were discussed. (S5O-01897)

Shona Robison (Scottish National Party, Dundee City East)

Ministers and Government officials meet regularly with representatives of all boards, including NHS Greater Glasgow and Clyde, to discuss matters of importance to local people.

Jackson Carlaw (Conservative, Eastwood)

With new local plans, local authorities very often resolve housing demands with the provision of major new estates. Although councils can provide for future education needs, community healthcare partnerships have to try to anticipate requirements for future health provision such as general practitioner services. Is the cabinet secretary satisfied that the process underpinning that is sufficiently robust and well resourced, particularly where a major new estate is created and the existing GP lists are at full capacity, as is currently the case in a particular example in my Eastwood constituency?

Shona Robison (Scottish National Party, Dundee City East)

The member makes an important point. We now have health and care partnerships working across health and social care and bringing in a housing element to those discussions. There is a need to ensure that, in planning for new house building, the local services that the residents will require, including health services and primary care services, are taken into account, and we expect our partners to do that. If we can do more in that space to ensure that that is done early enough, we will do so. As the member will appreciate, expanding any health service takes time, and there can sometimes be a mismatch between the planning process and the house building process. I am happy to communicate further with Jackson Carlaw on that matter, if he would find that helpful.

Cowdenbeath Football Club

Claire Baker (Labour, Mid Scotland and Fife)

12. To ask the Scottish Government what assistance it can provide to Cowdenbeath Football Club with its club 135 campaign, honour the past, ensure a future, which aims to secure the future of the club. (S5O-01898)

Aileen Campbell (Scottish National Party, Clydesdale)

I am aware of the good work that is being carried out in support of Cowdenbeath’s club 135 campaign. I know that the club has strong and deep roots in the town that date back more than 135 years. Like many football clubs at all levels in Scotland, Cowdenbeath is an important part of the local community, and I am encouraged by the spirit shown by the club, supporters and the wider community to raise £135,000 to help to build a sustainable future. I have instructed my officials to contact the club directly to discuss the campaign in more detail.

Claire Baker (Labour, Mid Scotland and Fife)

I welcome the minister’s response. As the minister recognises, the club is 137 years old and is very important to the local community. However, the club no longer has the large mining community that it used to have for its support, and the rent from the weekly market and the stock cars no longer comes to the club, as it lost its ownership of Central Park. An emergency general meeting and a public meeting had to be cancelled recently because of snow

, but the club is clearly in a mode of fighting for survival. I welcome the minister’s commitment that officials will contact the club. Will she join me in calling for locals and football lovers all over the world to help save the club?

Aileen Campbell (Scottish National Party, Clydesdale)

I am happy to lend my name to that call for people to get behind the club’s campaign. Fans are the lifeblood of Scottish football. Certainly, if anyone can make a difference to the club, it will be the supporters. I am happy to meet the member on the back of my officials’ meeting with Cowdenbeath Football Club and to do what we can to raise awareness of the supporters’ efforts.

The Deputy Presiding Officer

That concludes general questions. As we have half a minute before the next item of business, I would like to say something about the slot.

When we are handling portfolio questions, the Presiding Officers try hard to strike a balance in terms of supplementary questions. I have seen a few grumpy faces around the chamber this afternoon, but there has to be respect for members who have submitted questions and who have taken time with their supplementary questions. That must be borne in mind. It must also be borne in mind that, when people take far too long to ask questions, it means that we cannot take the questions of some of their colleagues. I ask ministers to reflect on that with regard to their answers, too.

Procurement

Linda Fabiani (Scottish National Party, East Kilbride)

The next item of business is a debate on motion S5M-10962, in the name of Jackie Baillie, on procurement.

Jackie Baillie (Labour, Dumbarton)

The public sector spends more than £11 billion a year procuring goods and services—billions on construction projects. I am sure that we can all agree that that is money that should support the delivery of public services, providing decent jobs and helping to grow the economy.

It is hardly controversial to say that public money should be spent for public good. However, in this area, I believe that we are being failed by the Scottish National Party. Instead of the economy growing, Scotland is flirting with a recession. Productivity is down, industry after industry reports massive skills shortages, and growth is all but stagnant. Instead of supporting the delivery of public services, the SNP outsources to companies such as Carillion, which has contracts worth at least £630 million with public sector agencies in Scotland.

There are companies that have engaged in the blacklisting of trade unionists and companies that have engaged in poor employment practices. It is simply not good enough for the Scottish Government to say that it is in favour of public services and workers’ rights when its actions undermine them.

Promises that were made during the passage of the Procurement Reform (Scotland) Act 2014 have yet to be kept. Guidance that was published by the Scottish Government to support the act is welcome, but clearly there is little monitoring of implementation. The first monitoring reports for 2017-18 are due soon, but the Cabinet Secretary for Finance and the Constitution will not be publishing a report until the end of 2018-19. Why do we need to wait so long?

Keith Brown (Scottish National Party, Clackmannanshire and Dunblane)

Jackie Baillie made the point that it is important that the actions that we take reflect the words that we use. Does she want to reflect on the massive extent of the outsourcing that was undertaken by the Blair Government, and also on the complete lack of action that was taken on the issue of blacklisting by Labour Governments from 1997 to 2010?

Jackie Baillie (Labour, Dumbarton)

Oh dear; I would hope that the SNP would raise its game. This is about what we do with public money in Scotland. I invite Keith Brown to think and act in accordance with what he says that he believes in, because we would support him if he were actually to engage in fair work practices.

I well remember the debates during the passage of the 2014 act. Five times, the SNP voted against the inclusion in the bill of the living wage—apparently because the European Union would not allow that. A year later, after a campaign by trade unions and the Labour Party, the SNP provided the living wage to care staff, which was welcome. At the time, John Swinney told local authorities that that was still against EU procurement rules but that we would be doing it anyway. It is amazing what one can do when one has the political will. It is a shame that the SNP does not want to take that approach in all public sector contracts, because, instead of investing in decent, well-paid jobs, the SNP is helping to line the pockets of directors and shareholders—directors of failing companies whose eye-watering bonuses and pensions are protected while former Carillion employees have the rug pulled out from under them.

I want to speak about two Unite workers on Carillion Network Rail contracts, the first of whom works on the extension to Waverley station. He said:

“The impact of me being on a zero hours contact is unacceptable. My partner and I have two young children under the age of 10. Since the collapse of Carillion I have been going without work for days and weeks at a time.

There is a clause in my contract that says that I cannot take other work with another company ... I have been missing wages ... we struggle to make ends meet. The worst came recently when, having been offered no work whatsoever for two weeks, I took the hard decision to apply for universal credit.

I am fit and able to work, however I am now having to resort to claiming state benefits in order to keep a roof over my family’s head and put some food on the table.

On top of all of this, when I do work, I am having money taken off my wages due to an umbrella company’s greed. This is public money for a public service, why are umbrella companies who add nothing of any value to the project I am employed on profiting from the tax payers money? Something needs to change and change very soon.”

Rail worker two is employed on the Shotts-Cleland electrification project. This is what he said:

“I wait for a text every Friday to say if I will be working the following week. If I go away with my family there’s a real chance that my place at work will be taken by another worker and I’ll have no work. If I take a day off I might be replaced, if I call in sick I might be replaced, if I don’t work every shift I’m offered, no matter how short noticed, I might be replaced.

I pay an umbrella company up to £100 a week to get my own wages. I have no holiday pay, no sick pay. I can’t work anywhere else if there’s no work for a few weeks. I also pay both employers and employees NI contributions.

Furthermore, I can’t plan a day out at the weekends in case I'm offered work. I’m paid the national minimum wage for a safety critical job due to the money the umbrella companies take.”

That is a national disgrace. We desperately need an urgent review of procurement to end the exploitation of workers.

Those are not a couple of isolated incidents. The Aberdeen western peripheral route has been plagued by allegations of bullying and harassment, health and safety staff have been undermined, agency worker regulations have been ignored, and the project uses subcontractors who have used gangmasters.

Another example are the agency workers who are hired by the Scottish Government through a temp agency. Agency workers are supposed to be short term and used to allow the Government a bit of flexibility. Some members may recall that, about three years ago, the Scottish Government was—rightly—embarrassed by the

Daily Record

into paying agency workers the same as its permanent employees. All sorts of promises were made then by the SNP about the use of agency workers. Those promises ring hollow today.

One of those agency workers has been in touch with me. She has been employed at Disclosure Scotland as an agency worker for five years. That is not about short-term flexibility; it is about avoiding making her a permanent member of staff. Shame on the Scottish Government for doing that. That agency worker does not get sick pay or holiday pay, and she has no job security. Many of her colleagues are being moved from night shift to day shift. If that happens to permanent employees, they continue to receive their shift allowance, but an agency worker for the Scottish Government gets nothing. Some of the agency staff are being let go because of a downturn in work. There is no redundancy payment; there is not even a goodbye.

I remind members that that agency worker has worked continually for the Scottish Government for five years in a temporary position. I will give members an idea of the scale of the situation. Last year, 80 workers were on one back shift in her work. Aside from the four team leaders, two were civil servants on permanent contracts—the rest were agency workers. The agency worker tells me that those who are being let go are told that they should not worry because they can get work at the new social security agency down at Atlantic Quay, with the Scottish Government. Apparently, the agency is hiring a lot of agency staff. Is that what we should expect of the new flagship Scottish Government agency? Really—temporary staff? The Scottish Government could make them permanent.

This is the truth about procurement by the Scottish Government: those contracts, which are signed off in St Andrew’s house, are leading to the exploitation of workers at Shotts. Those decisions, which are taken by the transport minister, are leading to zero-hours contracts at Waverley station. Those decisions, which are taken by the economy secretary, are leading to the use of subcontractors with a history of using gangmasters. Those are the decisions of the Scottish Government, where agency workers on lesser terms and conditions are employed for years instead of permanent staff. That is the SNP supply chain. It is using Scottish taxpayers’ money to support the exploitation of Scottish workers, and that absolutely needs to end right now.

Then, of course, there is the troubled Scottish Futures Trust. We should not let the SNP fool us. Its method of financing construction projects is a variation of the private finance initiative. A report that the Scottish Labour Party commissioned from well-known economists, Margaret and Jim Cuthbert, exposes a range of problems. The current approach is cloaked in secrecy. There is evidence of secondary market sales of debt, which nets the equity investors up to three times the original capital that they put in. It is a bit like someone going to Wonga for a mortgage when they do not have to. We know that private financing now costs more than borrowing through the Public Works Loan Board—in fact, it is double the cost.

John Mason (Scottish National Party, Glasgow Shettleston)

Will the member give way?

Jackie Baillie (Labour, Dumbarton)

I will in one second.

One local authority could apparently get a loan from the Public Works Loan Board for 2 per cent interest, but it was forced by the SFT to use its private lender, with an interest rate of 4 per cent. I am happy to give way, and I invite the member to say whether he considers that to be good value for money.

John Mason (Scottish National Party, Glasgow Shettleston)

Does the member at least accept that that is better value for money than the PFI projects that Labour supported?

Jackie Baillie (Labour, Dumbarton)

If the member looks at Margaret and Jim Cuthbert’s report, he will see that their analysis suggests that the costs are absolutely the same. I suggest that he looks forward and does something about it, because he should know that the changes that were made to the hub building programme, as a result of the changed classification of public sector projects, mean that there is no cap on profits, no need to meet procurement guidance and a greater role for the private sector. The result of all that is more private ownership, more private control, more private profit and less Government accountability—that is the SNP way of doing procurement.

We need an immediate review of the Scottish Futures Trust. It is not delivering value for money; it is simply delivering bigger profits for the private sector. Instead, Scottish Labour would empower the public sector to deliver contracts in house, because the SNP is not getting value for money.

Let us look at the example of Burntisland Fabrications. At least £3 billion is invested in renewables, but just a tiny proportion of that money stays in Scotland. As the GMB would rightly point out, think about the jobs and investment that our communities would benefit from if more of the supply chain and manufacturing was anchored in Scotland. However, there is no planning and no joining things up. There is no anchoring of the supply chain in Scotland. There is little consideration of small and medium-sized enterprises. As the Federation of Small Businesses has said, there would be a significant boost for Scottish local economies if more procurement money was spent with SMEs—how disappointing it is that we do not do enough of that. We need to get a bigger bang for our buck. We need nothing short of a wholesale review of procurement, which would include construction projects and facilities management projects—the lot. We need to do a lot better.

Scottish Labour believes that everyone who is on a public contract must be on the living wage. We believe that there should be an end to bogus self-employment, which employers use to save on national insurance costs. We believe that there should be no more zero-hours contracts, no more blacklisting, no more insecure work and no more agency workers on poor terms and conditions. There should be no more umbrella companies and no more contracts with tax dodgers. The differences that Labour in government will deliver are investment in SMEs, anchoring the supply chain in Scotland and decent, secure, well-paid jobs as part of all public contracts. That is the difference that a Labour Government will make in Scotland and, indeed, in the United Kingdom. Shame on the SNP for its complacency in allowing Scottish taxpayers’ money to be used to exploit Scottish workers.

I move,

That the Parliament believes that the procurement of goods, services and construction projects by the Scottish Government and the wider public sector should provide value for money, ensure that good employment practices are followed, have a supply chain that is anchored in Scotland and provide opportunities for businesses and jobs; regrets that the Scottish Government has failed to achieve these objectives, and believes that an urgent review of procurement, including employment practice and the operation of the Scottish Futures Trust, is required.

Derek Mackay (Scottish National Party, Renfrewshire North and West)

As Jackie Baillie has accurately pointed out, more than £11 billion a year is spent on goods, works and services across the public sector in Scotland. That is a substantial figure, and it represents a substantial contribution to our economy. It makes procurement one of our most powerful tools in helping us shape and deliver our ambitions for an inclusive society where the benefits of economic prosperity are shared.

The internationally recognised Scottish model of procurement takes into account a balance involving cost, quality and sustainability. It has four key strategic objectives—improving supplier access to public contracts; embedding sustainability in all that we do; maximising efficiency and collaboration; and delivering savings and benefits—and it has underpinned the significant progress that we have made over the past few years.

Our aim in creating public contracts Scotland in 2008 was for it to develop into a one-stop shop for advertising public contracts in Scotland, something that, not so long ago, was transformational in opening up public spending to the SMEs that Jackie Baillie mentioned. That aim is now a reality. The Procurement Reform (Scotland) Act 2014 introduced a mandatory requirement, and in the last financial year, public bodies advertised more than 15,000 contracts on public contracts Scotland, 75 per cent of the suppliers that were awarded the contracts had a Scottish address and four fifths of those suppliers were SMEs.

We are also delivering savings to allow money to be reinvested in public services. Collaborative procurement is continuing to deliver more than £150 million per year in savings. In fact, from financial year 2008-09 to date, Scottish Government-led collaborative procurements have generated just short of £1 billion in savings.

However, as members will know, our focus goes beyond savings and efficiency to considering how we can open up opportunities for businesses of all sizes to compete for public sector work.

Jackie Baillie (Labour, Dumbarton)

The cabinet secretary talks about savings, but I cannot help but wonder whether some of those savings have been made on the back of poor terms and conditions for workers. Why does the Government not engage in fair work practices? What about the rail worker in Shotts or the agency worker in Disclosure Scotland?

Derek Mackay (Scottish National Party, Renfrewshire North and West)

The member raises a key point that I am just about to turn to. I think that savings, efficiency, collaboration, and growing and diversifying our economy are important, and they are part of—and absolutely not instead of—our procurement strategy. This is all about

supporting

community benefits, creating jobs for people from priority groups and supporting apprenticeships, work experience and training opportunities for our young people.

Neil Findlay (Labour, Lothian)

Will the cabinet secretary give way?

Derek Mackay (Scottish National Party, Renfrewshire North and West)

No.

All those things are features of our procurement policies. We are also

using public procurement to drive fair work practices in our public contracts. Statutory guidance that was published in 2015 requires all public bodies to have regard to fair work practices in relevant contracts.

Claudia Beamish (Labour, South Scotland)

The cabinet secretary talks about striking that balance for the future of the economy in Scotland, but my concern—and the concern of Scottish Labour—is about the number of companies that are actually offering their employees the living wage.

Derek Mackay (Scottish National Party, Renfrewshire North and West)

I have a great deal of sympathy with what Labour wants to achieve, but the problem is that the actions of the Labour Party and Labour Governments have ensured that we do not have powers over employment legislation and other matters, which has impeded progress in this area. That is why when I talk about the important and significant matter—

Claudia Beamish (Labour, South Scotland)

Will the cabinet secretary take another intervention?

Derek Mackay (Scottish National Party, Renfrewshire North and West)

I am still answering the member’s previous one.

It is important that we recognise the legal constraints that we have to work within. Within those constraints, we have gone to the max on issues such as fair work and the living wage, and that is why it is so important that we keep the powers that we already have in relation to procurement in Scotland and do not allow the Tories to have their power grab and take them away from us.

We have been able to include other features such as

the payment of the living wage, dealing with inappropriate use of umbrella companies or zero-hours contracts and recognition of trade union representation or workers’ voices more generally.

We are currently working with public bodies to develop best practice guidance that will help them implement the statutory guidance and promote fair work in their procurement decisions. We continue to work closely with the fair work convention to ensure that we support the five dimensions of the fair work framework in all that we are doing.

Blacklisting has been mentioned, and it is important that I highlight our action to tackle that. Scotland has gone further than any other part of the United Kingdom in addressing blacklisting in public contracts, despite the fact that employment law is reserved. Since 2016, it has been the law that Scottish public bodies must exclude businesses from competitions if they have committed an act prohibited under the Employment Relations Act 1999 (Blacklists) Regulations 2010 until they have taken appropriate remedial action or a period of three years has elapsed. That is the longest period allowed for under EU law.

Neil Findlay (Labour, Lothian)

Will the cabinet secretary take an intervention on that point?

Derek Mackay (Scottish National Party, Renfrewshire North and West)

I have two minutes left and have further remarks that I think are important to make.

Recent weeks have seen the liquidation of Carillion, a major contractor with the public sector across the UK. Our first thoughts are naturally with the Carillion employees, who will be concerned for their jobs, and we have taken steps to support the men and women affected. Indeed, I understand that more than 90 per cent of former Carillion employees on the Aberdeen western peripheral route site have been transferred to the other two contractors on the project.

It is no accident that Scotland’s public services are not as badly affected by the collapse of Carillion as those elsewhere in these islands. We have not entered into the wholesale use of private firms to deliver public services in the way that the UK Government has. That means that our schools, our prisons and our hospitals are not at risk.

Decisions around how and when to involve the private sector must be taken sensibly and with a view to the long term, unlike those involving the PFI projects, with their excessive private sector profits, that we inherited from previous Labour Administration.

Jackie Baillie (Labour, Dumbarton)

Will the cabinet secretary take an intervention?

Derek Mackay (Scottish National Party, Renfrewshire North and West)

I have 40 seconds left. I am addressing questions that Jackie Baillie raised.

The transparency of decision making in procurement is also key. The Procurement Reform (Scotland) Act 2014 requires public bodies with a significant procurement spend to publish a procurement strategy. Bodies that have published a strategy will shortly be required to publish their first annual procurement reports under the act. Those will be used to prepare the Scottish ministers’ overview report of procurement activity across Scotland, which we aim to publish by the end of the coming financial year. We are confident that that report will tell a positive story, because we are proud of the progress that we have made in reforming public procurement over recent years, but of course we will look to see what further action we can take.

The UK Government’s shameless attempts to grab the power to regulate public procurement away from this Parliament, under the guise of Brexit, are not only an affront to the principles of devolution, but threaten to undermine everything positive that we have done in the procurement area. In the UK, it is only Scotland that requires, by law, that any decision to award a contract is based not solely on price, but on quality too. In the UK, it is only Scotland that requires, by law, that companies that have engaged in blacklisting are excluded from procurement procedures. In the UK, it is only Scotland that requires, by law, that public bodies consider community benefit requirements in major contracts. That is progress that we have made and it should not be taken away and handed back to Westminster’s control.

I move amendment S5M-10962.2, to leave out from “that the Scottish Government” to end and insert:

“the threat posed to the Scottish Government’s ability to continue to lead the way in promoting sustainable procurement by the UK Government’s attempts to use withdrawal from the EU as an excuse to take devolved powers away from the Parliament, and welcomes the Scottish Government’s plans to publish a report of procurement activity in Scotland by the end of financial year 2018-19.”

The Deputy Presiding Officer

I call Jamie Halcro Johnston to speak to and move amendment S5M-10962.3. You have seven minutes.

Jamie Halcro Johnston (Conservative, Highlands and Islands)

Thank you, Presiding Officer.

The importance of procurement policy in how Government operates should not be underestimated. The Scottish Government, not to mention our local councils, is responsible for the stewardship of £11 billion—money that is transferred from the taxpayer to external bodies in expectation of an appropriate return. Because of that, value for money should be uppermost in our thoughts on these issues, and I welcome the inclusion of value for money as a central point in the Labour Party’s motion today.

We are, it must be remembered, using public funds and are entrusted to ensure that those public funds are well spent. Procurement problems often end up in the national news, not simply out of journalistic desire to fill column inches, but because the public—quite rightly—get frustrated when the use of their money does not meet the standards of propriety that they would, and should, expect.

A positive feature in recent years has been the opening up of the procurement system across the UK, but it is by no means perfect. Although advances have been made to make procurement more accessible, it can still be unnecessarily complex and create barriers to the greater involvement of small businesses. If we want to ensure that there is an element of fairness in all of this, scale should not determine a business’s ability to compete.

One significant achievement at the UK level came in 2013-14, when the pledge to procure a quarter of the value of central Government’s goods and services from SMEs was met. Increasing the involvement of SMEs, the third sector and supported businesses was also a key priority in the Scottish Government’s procurement strategy, so it is disappointing to hear that the proportion of local authority procurement from SMEs in Scotland has fallen in the past five years.

The Scottish Government’s economic strategy also points to the benefits that procurement can provide and observes that it can be a driver of innovation and sustainability through the powers granted under the Procurement Reform (Scotland) Act 2014. The act was a significant piece of legislation but, in many ways, we find ourselves rehashing the old debates that took place during its consideration. We must be cautious in assuming that procurement policy can be used to cure all ills in our economy.

In truth, there is a balance to be struck. Procurement can be used to promote responsible business practices, but that must not come at the cost of raising the barriers for entry into the procurement marketplace. That includes the price not only of compliance, which may be justifiable, but of additional reporting and monitoring. Although the consequences of too great a regulatory burden may be unintended, they would also be inevitable. Such a burden would reduce the social good of involving small businesses and encouraging local procurement and, ultimately, there would be an impact on the value for money that we hope to achieve.

Employment standards are, of course, a significant issue. In addition to the areas outlined by Labour, there could be an opportunity to encourage more investment in the skills, training, apprenticeships and employee development that the modern economy will require. However, we will struggle to do that coherently if the needs of businesses are not considered.

Our existing procurement policy continues to be far from perfect. Some level of inefficiency will always be a feature of the system, but there are several areas where we still have some distance to travel.

The fiasco of the Scottish Government’s approach to information technology projects has rightly outraged many. Not only have costs escalated out of control in several areas, but projects have been delivered years behind the forecast delivery dates or dumped after considerable investment, as with the Scottish Prison Service’s finance system. The most pressing example for my constituents must be the handling of the farm payments system, which has cost many dearly at a time when farming incomes were already being squeezed.

There are, of course, areas where we could look to make positive innovations. Some work has taken place to uncouple large contracts to ensure that smaller businesses can compete, but it is far from enough. Millions of pounds are administered in supporting the roll-out of broadband but the process is slow, unwieldy and delivered through two separate schemes but with a single contractor. Support for other delivery providers on smaller projects through Highlands and Islands Enterprise seems to leave space for improvement.

In my region, the procurement of ferry services is under review, although we received some preliminary findings in December through Transport Scotland. That procurement procedure seems to have been a relative success in the past, with local people and businesses largely supportive of the current operator, Serco NorthLink. However, it now appears that the Scottish Government might be minded to bring those services in house again with a public operator.

The Labour Party’s motion refers to businesses having

“a supply chain that is anchored in Scotland”.

I want to steer us away from any sense of the Parliament taking a protectionist or insular stance, and I do not think that that is what the motion intends. The debate is not a moment for crying “Scotland first” but, instead, a way of considering some of the benefits of local procurement, particularly at local authority level, in a way that reflects our interests in value for money and wider sustainability.

In another example from my region, livestock farmers in Shetland whom I recently had the pleasure of meeting observed that they had greater capacity to supply to schools, hospitals and care homes across the islands. Last year, Fergus Ewing observed that the Scottish Government “could do better” in that regard and pointed out that the majority of food in the public sector—52 per cent—is sourced from outside Scotland.

My colleague, Brian Whittle, will speak in more detail on food and drink procurement. However, on procurement generally, I welcome figures highlighted by the FSB Scotland, which show that Shetland Islands Council is the top-performing local authority for procurement from local SMEs, followed by Orkney Islands Council. Indeed, the Highlands and islands as a whole perform well on the matter, with Moray Council, Western Isles Council and Highland Council all performing above average.

There are obvious benefits to local procurement where it is available: it reduces environmental impact and increases the sustainability of local supply chains, and we gain a greater security of supply. Centrally directed policy should not stand in the way of such measures, and best value should reflect those wider interests. Perhaps some of the lessons from my region would be instructive for the country as a whole, given that, on average, only a fifth of councils’ procurement spend goes to local SMEs.

We diverge from Labour on the need for “an urgent review”. There is little explanation of why that demand arises, and although I hope that all parties are mindful that improvements can and ought to be made, we cannot simply accept that urgent reviews need to be called in every area of Government policy in which improvements are possible.

Lewis Macdonald (Labour, North East Scotland)

Will the member take an intervention?

Jamie Halcro Johnston (Conservative, Highlands and Islands)

I am just finishing.

I welcome this Labour Party debate, and I hope that the Scottish Government will offer a constructive tone going forward. It would be helpful if ministers expanded on existing work relating to sustainable procurement later in the debate.

I look forward to progress being made on reforming procurement in a sustainable way that lets us meet the needs of the public sector and take advantage of the wider economy.

I move amendment S5M-10962.3, to leave out from “an urgent review” to end and insert:

“the Scottish Government should encourage and increase the use of sustainable procurement practices to cut wasteful spending.”