Scottish Parliament, 12 February 2009

334 contributions from 77 members. The official report.

Official Report 12 February 2009

Oath

Alex Fergusson (None, Galloway and Upper Nithsdale)

I invite our new member for Glasgow, Anne McLaughlin, to take the oath of allegiance.

The following member took the oath:

Anne McLaughlin (Glasgow) (SNP)

Health Care Associated Infections

Alex Fergusson (None, Galloway and Upper Nithsdale)

The next item of business is a debate on motion S3M-3428, in the name of Cathy Jamieson, on health care associated infections. I remind members that one-minute warnings are no longer given during debates in the chamber.

Cathy Jamieson (Labour, Carrick, Cumnock and Doon Valley)

Labour has chosen this subject for debate this morning as the issue of effectively tackling health care associated infections is vital to ensuring patient confidence as well as patient safety. I particularly welcome Michelle Stewart and members of C Diff Justice Group and others who are in the public gallery.

I pay tribute to the families and members in all parties who have worked hard to raise awareness of the issue and ensure that it is taken seriously by the Scottish Government. I pay particular tribute to Jackie Baillie, who has campaigned tirelessly on behalf of her constituents who have been so deeply affected by the Clostridium difficile outbreak at the Vale of Leven hospital.

Our motion is designed to build on the consensus that was shown when Parliament voted to back calls for a public inquiry into events at the Vale of Leven. That was an important decision and, because Parliament has already decided to support that inquiry, we did not refer to it in our motion. However, we recognise why the Liberal Democrats have lodged an amendment to reinforce that position, and we therefore intend to support it.

We must look to the wider context. As the Health Protection Scotland report confirmed last year, the problem is not associated with only one hospital—indeed, it is not associated only with hospitals, as care in the home, primary care and care homes are all potentially involved. Although we recognise that the occurrence of HAIs is not new and might to some degree be inevitable in health care settings, there is no room for complacency. Indeed, as the British Medical Association has pointed out, the fact that we have an ageing population, combined with advances in medical technology and the ability to treat more severe and chronic disease, means that there are more patients who are potentially vulnerable.

In 2005, NHS Quality Improvement Scotland estimated that about 33,000 patients each year develop infections in hospitals alone. Research suggests that HAI is a major factor in around 450 deaths each year and contributes to around a further 1,300 deaths. As C diff became apparent as a serious problem, the Labour-led Executive established the HAI task force, which first met in March of 2006 on the back of a considerable amount of work that had already been done on antibiotic policy, hand hygiene and cleanliness.

I know from hearing the Cabinet Secretary for Health and Wellbeing speak that she is personally aware of the impact that C diff can have on individuals and families. I hope that the debate and vote today will demonstrate that Parliament is united in its resolve to see further action taken to tackle the problem effectively.

We welcome the report of the expert team led by Professor Cairns Smith that was published earlier this week and which shows that progress has been made at the Vale of Leven. Vital refurbishment work is being carried out to ensure that infection control measures are effective. Impressive progress has been made on reducing the use of antibiotics, and the prescribing strategy is being carefully implemented and monitored—and, indeed, extended to primary care.

We acknowledge that steps are being taken to offer the public easy access to all published information on hospital infection rates and hand-hygiene compliance, although there are concerns with the validity of the some of the compliance data. We welcome the announcement in January that, after some pressure from Labour, a web portal on the Scottish Government's HAI task force website will include links to information from all national health service boards and hospitals. Hospital-by-hospital reporting, for which members from across the chamber have been calling for some time, is also a significant step forward.

However, we believe that there are areas in which we can make further progress, which is why we are seeking Parliament's support for the implementation of our 15-point action plan, which has been endorsed by Professors Hugh Pennington and Brian Toft. I do not have time to detail each of the 15 points, but it is important to highlight a number of key points. First, we believe that it is appropriate to set a target to reduce the rate of Clostridium difficile cases by 50 per cent by March 2011. The Scottish Government target of reducing C diff cases by 30 per cent over the next three years is welcome, but it is less than the reduction that the NHS in England has already achieved.

Provision of isolation facilities for all C diff or MRSA patients must be a priority. We recognise that that cannot happen overnight, but the Scottish Government must set out a clear timescale for it to be achieved across the NHS and ensure that the resources are in place to ensure that it happens. Similarly, we want a programme to be put in place that will provide temperature-controlled, sensor- operated, flow-regulated taps for hand washing, appropriately positioned in all wards.

The Government's latest drive to improve hand hygiene among health care staff will result in members of staff who repeatedly fail to meet hand-hygiene requirements being disciplined. Although it is important that standards are met, the BMA and the Royal College of Nursing agree that that approach will work only if all the appropriate facilities to allow effective and timely hand hygiene are first put in place to enable staff to meet the requirements that are placed on them.

As identified in the report that was published on 10 February 2009, the Scottish Government needs to implement national NHS dress code guidance. We also need immediate guidance from the Crown Office and the chief medical officer to address the need for clear data on fatalities arising from health care associated infections.

I appreciate that there can be reluctance to introduce more tsars or commissioners into our system, but given the numbers of people who are involved in monitoring—I am sure that my colleague, Richard Simpson, will expand on that later—I believe that there is a need for one person, whom we have described as an HAI commissioner, to develop best practice, co-ordinate action and bring a sharper focus to what is recognised as the institutional clutter of the agencies that are responsible for tackling HAIs.

HAI is a vitally important and serious issue for our NHS, and I am not suggesting that our 15-point plan is the final word on what needs to be done. Others might suggest additional reasonable and practical measures. In light of that, we believe that it would be right and proper for the cabinet secretary to continue to formally report progress to Parliament.

The plan has been drawn up in consultation with two acknowledged experts, who have publicly backed it. It also has the backing of the families who are involved in the C Diff Justice Group. I believe that it commands support across a wide range of people, including the members here today, and I therefore commend it to Parliament.

I move,

That the Parliament welcomes the 15-point plan for tackling healthcare associated infections drawn up with the assistance of Professor Hugh Pennington and Professor Brian Toft and endorsed by the C.diff Justice Group, which represents the latest group of families to be affected by this problem; notes that the plan proposes a range of measures, including a revised target to reduce Clostridium difficile in hospitals by 50% by March 2011 compared with the current target of 30%; believes that comprehensive strategic action is required to tackle healthcare associated infections, and calls on the Cabinet Secretary for Health and Wellbeing to implement this plan alongside other measures to combat healthcare associated infections and report regularly to the Parliament on the Scottish Government's progress in tackling this issue.

Nicola Sturgeon (Scottish National Party, Glasgow Govan)

I welcome this debate as it allows me to reinforce further the importance that the Government places on driving down health care associated infection rates in our hospitals.

As members know, our comprehensive work programme is being overseen by the Scottish Government's HAI task force, whose expert members include people with clinical, scientific and education backgrounds as well as members of the public. It is also backed by record investment. We have increased investment by 260 per cent over a three-year period, which demonstrates the importance that the Government places on tackling infections.

It is vital that public confidence in the national health service is maintained. I am all too aware of the anxiety that patients and their families face in relation to the risk of infection when in hospital. That is why it is right that information about hospital performance on key indicators such as MRSA and C difficile rates, hand hygiene and environmental cleaning is published so that the public can understand how their local hospitals are performing.

In January, we announced the introduction of a new national reporting template for that purpose. It will require NHS boards to publish hospital-by-hospital performance on HAI and to discuss that level of detail at board meetings. It will ensure that the link from ward to NHS board is made, and it will allow for greater transparency about levels of infection at both local and national level. The national HAI task force website has also been developed to act as a portal through which the public can access such information.

We have also set stretching targets for our NHS to reduce the levels of infection and improve standards of cleanliness and hand hygiene. I announced last year that a national target will be introduced to reduce C difficile rates by at least 30 per cent by March 2011—I stress that that is a minimum target. Delivery of that target has been underpinned by the provision of an additional £2 million to boards to ensure that local surveillance systems are further improved to track the progress that is being made.

We have also introduced a zero-tolerance approach to non-compliance with hand-hygiene policies. That is a cornerstone of the action plan, and all chief executives have received clear guidance on how it must be implemented at board level.

Our national approach to the monitoring of HAI performance at NHS board level will be further strengthened by establishment of the new care environment inspectorate. It will come into force from April 2009 and will ensure through a rolling programme that every acute hospital in Scotland is inspected when necessary on a random and unannounced basis. I will make a further announcement on the detail of the inspectorate and its leadership in due course.

Richard Simpson (Labour, Mid Scotland and Fife)

Where will the new care environment inspectorate sit within the organisational structures that are currently involved in tackling HAI?

Nicola Sturgeon (Scottish National Party, Glasgow Govan)

As our consultation indicated, the care environment inspectorate will sit within NHS Quality Improvement Scotland, but further details on its governance and leadership will be announced shortly.

Other actions that we have taken include: implementation of a pilot MRSA screening programme and preparations for a national roll-out from next year; a requirement for all new-build hospitals to provide 100 per cent single-room accommodation for patients; integration of the cleanliness champions programme into nursing and medical undergraduate curricula; toughening up of cleaning standards; funding for antimicrobial pharmacists; and a new dress code and new national uniform for NHS Scotland from later this year.

There is no room for complacency, but our comprehensive programme is having an impact. MRSA rates are at their lowest since surveillance began and, although it is too early to determine any trends, C difficile rates are down by 17 per cent on the previous quarter and 2 per cent on the same quarter last year.

I am fully aware of the detail of the Labour Party's 15-point action plan. Much of what is in it is already happening in Scotland, but I have formally asked the HAI task force to review the detail of the plan and consider the adoption of any actions in it that it considers will add value to our existing work programme.

This issue is not about party politics: the combined efforts of everyone in this Parliament, as well as the entire Scottish population, are required if we are to succeed in reducing infection rates. That is why the Government has already agreed to carry out a study on the electronic bed management system, which is being piloted in NHS Grampian and is supported by the Scottish Conservative party, to ensure that lessons learned from its use are available to other NHS boards quickly. I will consider ideas about how better to tackle infection from wherever they come.

The outbreak of C diff at the Vale of Leven hospital brought into sharp focus the challenge of tackling infection. The independent review team that I established to look into the events at the Vale of Leven hospital produced a report containing seven key recommendations. Supported by family and patient representatives, the review team published its follow-up report on Tuesday. I was encouraged by its findings, which confirmed that progress had been made on all the recommendations. Building sustainability in each of the seven areas will be crucial to maintaining the significant progress that has been made.

It is essential that we learn lessons from the tragedy, and I fully understand why repeated demands for a public inquiry have been made. Let me make it clear again that I have not ruled out a public inquiry. However, the fact remains that there are on-going detailed and complex investigations by the procurator fiscal, police and the Health and Safety Executive that, unlike the report published this week, are about looking back at what went wrong. While those investigations are under way, there would be a real risk of prejudice to any possible criminal proceedings and a risk of inhibiting a public inquiry doing its work. However, as I have said before, I will return to the Parliament to make a statement on any further action as soon as the views of the Crown Office are known.

I hope that everyone in Parliament recognises the priority that this Government has given to tackling infection. It is a big and difficult challenge, but I am committed to ensuring that we succeed. I look forward to hearing other members' speeches and will consider any positive suggestions that they make.

I move amendment S3M-3428.2, to leave out from "welcomes" to end and insert:

"acknowledges the high priority that the Scottish Government is placing on tackling and driving down healthcare associated infection, backed by investment of £54 million; notes that a national action plan is in place and that a national reporting template has been introduced to ensure that NHS boards have the necessary policies and practices in place to drive forward improvements in areas such as governance, leadership and surveillance; further notes that NHS boards are now required to report publicly on hospital by hospital performance on MRSA and Clostridium difficile rates, environmental cleaning and the causes of adverse incidents; further acknowledges that a target of a minimum 30% reduction in Clostridium difficile rates by 2011 is in place and that there is a zero tolerance approach on hand hygiene; also notes that the Healthcare Associated Infection Task Force has been asked to consider implementation of the elements of the Labour Party's 15-point plan not already underway, and further notes that the Scottish Government has agreed to progress the electronic bed management system supported by the Conservative Party and that the Cabinet Secretary for Health and Wellbeing will report regularly to the Parliament on the progress being made on tackling healthcare associated infection."

Ross Finnie (Liberal Democrat, West of Scotland)

This is certainly not the first time that the Parliament has addressed what is undoubtedly a crucial issue and one which the public rightly feels quite sore about. When someone goes to hospital there is a presumption that they will get well rather than acquire another infection, so there is a great deal of pressure on politicians to respond to the real and understandable public concern.

I welcome the work that the Labour Party has initiated and, in particular, the fact that it has used two experts to consider what might be required to bolster how we tackle HAI. It is particularly welcome that it added the name of Professor Pennington, who is well known to most people and is highly regarded in the field. The 15-point plan is a useful contribution: it leaves very few stones unturned and adds considerably to the debate. I am sure that the statement in the cabinet secretary's amendment that the HAI task force is considering how to implement the 15-point plan is genuine, and I hope that we can have a realistic expectation that this thought-out proposal—which as Cathy Jamieson said is not necessarily a party-political one but a plan that has been thought out by experts—will be taken on board and genuinely meshed in.

Although the 15-point plan makes a substantial contribution to the debate, it would be churlish of us not to acknowledge that the Government has set in train a number of measures that are contributing to the action to eliminate and eradicate the incidence of HAI across the health service in Scotland. There has been a substantial increase in the cash that has been allocated to address the problem over three years, which reflects the increase in the incidence of HAI infections across the health service. The initial report that came before us from the Smith inquiry indicated that there was a serious fault and a serious omission in monitoring and reporting and that that was one of the major problems behind the failure to identify the increasing incidence of the disease. Much of what is required has now been put in place.

I am glad that, in addition to acknowledging the 15-point plan, the cabinet secretary acknowledges in her amendment the proposals from the Conservative party on dealing with electronic bed management. I am also pleased that the reporting standard that she has set is on a hospital-by-hospital basis. All too often—on a range of issues—members have felt frustrated when figures have been aggregated on a health board basis, which masks the situation and makes it almost impossible to track down where the real problems are and where solutions are required.

As the cabinet secretary indicated, we continue to agree to disagree on the need for a public inquiry. If Professor Cairns Smith can continue both to monitor progress and to make recommendations that entail finding fault—finding things that need to be improved—I find it increasingly difficult to accept that a thorough review should not be carried out by a public inquiry, in the public glare and open to public scrutiny. Although the families have welcomed Cairns Smith's findings, how those are arrived at and determined is not open to public view.

I know that the cabinet secretary is strongly of the view that holding a public inquiry would imperil any further police inquiry. I repeat what I said when the issue was last debated: if at any point the Lord Advocate indicated to a public inquiry that its continuance was putting in peril a proper legal proceeding, the inquiry would be sisted. I stand by that position.

I move amendment S3M-3428.1, to insert at end:

"and, given that the cabinet secretary has deemed the publication of the report of the independent review team on Clostridium difficile at Vale of Leven Hospital as not being prejudicial to the police inquiry, calls on the Scottish Government to establish a public inquiry immediately."

Mary Scanlon (Conservative, Highlands and Islands)

Scottish Conservatives want a health service in Scotland where patients and their families do not fear hospital admission due to health care acquired infections, which not only add to a patient's stay in hospital and suffering but, as we all know, can be fatal. Patients throughout Scotland should have confidence in the hygiene and cleanliness standards in our hospitals. They also need to understand why there should be a reduction in the prescribing of antibiotics.

We welcome as a major contribution to tackling hospital-acquired infections the 15-point plan that has been drawn up by Professors Pennington and Toft, which is mentioned in the Labour motion. We endorse the proposal to raise the target for the reduction of C diff in hospitals to 50 per cent, compared with the current minimum target of 30 per cent, and we therefore support the Labour motion. However, the measures that we are addressing today come against the background of an ageing population, more patients and more severe and chronic diseases being treated, higher bed occupancy and more patients vulnerable to infections, alongside a higher turnover of patients and, in some health care settings, inadequate standards of hygiene.

The British Medical Association briefing on health care associated infections highlights the need to inform and manage patient expectations regarding antibiotics, as much prescribing is heavily influenced by patient pressure. The BMA states:

"Complacency, poor prescribing practice and misuse of antibiotics are major factors in the emergence of drug resistant infections."

I make that point today, as it is often lost in debates on hospital infections.

As Cathy Jamieson said, the 15-point plan is not exclusive, and neither do we want to give the impression that only the Vale of Leven hospital needs to address the issue of hospital-acquired infections. Lessons that have been learned need to be applied throughout Scotland. The Scottish Conservative bed management and hospital-acquired infection information technology system would be of enormous benefit in tackling infections; we thank the Scottish Government for its budget commitment to the issue.

In the best of Scottish traditions, where there is a problem, there are innovations. A small company in Inverness has developed an MRSA home testing kit, which saves time, travel to hospital and delays to surgery—in my opinion, it ticks all the boxes. I have sent a copy of a paper on the kit to the cabinet secretary.

I welcome the guidance on death and the procurator fiscal that the Crown Office and Procurator Fiscal Service has issued to medical practitioners. It includes guidance on any hospital-acquired infection, and I look forward to further clarification from the Crown Office. Many families have been fully aware that a hospital infection was either the direct cause of or a significant contributory factor in their relatives' deaths, but in recent years the NHS seems to have been reluctant to include any mention of such infections on death certificates. We welcome further clarity on the issue, as well as the other measures that have been announced. In the longer term, I hope that we will look at the design of our hospitals, including air conditioning and heating systems. The debate has been diverted on to the issue of private contracting, but it is for the NHS to ensure that standards set are standards met.

Today we will support the Government amendment but not the Liberal amendment, as we have already debated and voted on the issue of a public inquiry.

Alex Fergusson (None, Galloway and Upper Nithsdale)

As members will have picked up, there is a little flexibility on timings. I know that they will not abuse it.

Jackie Baillie (Labour, Dumbarton)

How can I refuse that invitation, Presiding Officer?

I welcome to the public gallery families from the C Diff Justice Group and representatives of many other families that have been affected by Clostridium difficile in hospitals across Scotland. I join other members in welcoming Hugh Pennington, emeritus professor of microbiology. I owe Professor Pennington and Professor Brian Toft, one of the United Kingdom's leading authorities on patient safety, an enormous debt of gratitude, because they gave up their time over Christmas to shape the 15-point action plan that is before the chamber today. The plan was also endorsed by the C Diff Justice Group.

I commend the plan to Parliament. It is not intended to be the final word on health care acquired infections. New microbes are evolving in real time, and all of us need to be open to new ideas in our constant battle against infection. Although the incidence of C diff may be constant, the number of cases has risen by 10 per cent over the past year, and new, more toxic strains are emerging.

It is just over a year since the outbreak of C diff started at the Vale of Leven hospital. Mary Scanlon was right to say that health care acquired infection affects not just that hospital but hospitals throughout Scotland, but the families cannot wait any longer. I call on members today to make 2009 the year in which we in Scotland get serious about tackling all health care acquired infections.

At the heart of the plan is a 50 per cent reduction in C diff cases by March 2011, rather than the Government target of 30 per cent over the same period. I will tell the chamber why. In England, the target has already been exceeded—cases of C diff are down by 38 per cent. In Maidstone and Tunbridge Wells, where there were significant outbreaks of C diff, the local target is to wipe out MRSA completely and to reduce C diff infections by 55 per cent by April 2011. Our target applies only to people over 65; in England, the target applies to everyone, from the age of two upwards. We need to be more ambitious. Raising the target will signal the seriousness of our intentions and drive change, if it is backed by a range of actions and resources.

The Royal College of Nursing was right to point out to the Health and Sport Committee and in a briefing to members that the sum of £54 million over three years that has been allocated to deal with HAIs is unchanged from the original spending review figure of 2007. I acknowledge that money and welcome it, but not one penny extra has been made available, despite the fact that 2008 witnessed the worst outbreak of C diff in Scotland, if not the UK.

I will deal briefly with a couple of issues, starting with hand hygiene. The cabinet secretary reports compliance rates of 93 per cent, but we are not measuring like with like across health boards. The number of observations varies in different hospitals and health boards. Our approach must be more rigorous than simply relying on self-assessment by clipboard. We need temperature-controlled, sensor-operated washing facilities in all hospitals. It is embarrassing that there are better facilities in our airports than in our hospitals.

The cabinet secretary announced that all new hospitals will have single rooms, to help to reduce infections. I welcome that, but there is no timescale or outline of resources for the programme. It will take more than a generation to cover the whole NHS estate, but we need a crash programme now—isolation facilities must be available in every hospital. Our proposal is proportionate, targeted and, therefore, more deliverable.

Turning to the Liberal amendment, the Parliament has already voted to support a public inquiry and, two weeks ago, the Public Petitions Committee unanimously agreed on the need for a public inquiry without further delay. The committee did not consider that on-going proceedings would be prejudiced, which is welcome.

Today, we have a chance to move the agenda on. We need a comprehensive strategy, not a piecemeal approach. Yesterday, the Tories and the Liberals supported the Labour motion that is before us today. Support for the Scottish National Party amendment would remove the support for implementing the 15-point plan. The Parliament will not be forgiven if we allow that to happen.

Christine Grahame (Scottish National Party, South of Scotland)

First, I extend my condolences to the families and friends of those who have died at the Vale of Leven hospital and elsewhere as a result of C difficile infection and other hospital-acquired infections. One death in which hospital-acquired infection is the main cause is one death too many.

In the period from May to August 2007, a link was established between the deaths at the Vale of Leven and C difficile. I, too, do not wish to politicise what should be a consensual debate. Families, especially those with elderly relatives in hospital, deserve better from the Parliament. It is undeniable, however, that between 2001 and 2006 the number of cases in which C difficile was mentioned as the underlying cause of death or as contributing to death rose from 170 to 417—a 145 per cent increase. That said, I commend Jackie Baillie for rightfully and tenaciously pursuing the issue on behalf of her constituents so that we may all be confident and comforted that when we go into hospital we will, as Ross Finnie said, get better rather than worse through infection that can and should be avoided. I acknowledge Cathy Jamieson's important point that the quality of care and hygiene extends beyond our hospitals, into care homes, nursing homes and elsewhere.

Historically, the Vale of Leven hospital has been under threat of closure, which must have contributed to the hospital's decline and to falling morale among its staff. The independent report disclosed that surveillance systems were inadequate and that, in clinical and patient toilet areas, there was a serious lack of dedicated hygiene practices and equipment.

As is sometimes the case in our world, it took a particular tragedy—in this case concerning the failure of basic hygiene at the Vale of Leven—to shine a harsh light on an issue that many of us were already aware of anecdotally. I remember visiting my late mother when she was terminally ill in hospital some time ago. The walls were dirty. The family worked on a rota system to check that she was being properly cared for and kept clean when she was unable to move. It is a story that others have heard, too.

The cabinet secretary spoke about the action that is being taken and the £54 million that is being spent over three years to tackle hospital-acquired infection. That is a 260 per cent increase in spending. I think that members throughout the chamber recognise that, whoever is in government, the issue has to be taken very seriously and funding has to be provided.

I recognise the simple measures that the cabinet secretary is taking, which will assist with the situation. In particular, there is to be no more privatisation of cleaning. I know that it was not privatised at the Vale of Leven, but there is no doubt that when cleaners, porters, nurses and others feel that they are part of a team in a hospital, they work together and take pride in what they do. People who come through on contract work do not have the same engagement with the hospital.

Richard Simpson (Labour, Mid Scotland and Fife)

I hope that Christine Grahame will acknowledge that it was Sam Galbraith who said, when he was a minister, that there should be no further privatisation of cleaning. That approach has been in place for almost a decade.

Christine Grahame (Scottish National Party, South of Scotland)

I am content to acknowledge that. My point—and the member is perhaps agreeing with me—is that when all the staff in a hospital are part of a team, there is a different kind of morale and a certain kind of commitment.

Among the other measures that the cabinet secretary has announced today that I welcome are those concerning nurses' uniforms. It is not appropriate for nurses to take their uniforms home to be cleaned or to travel on buses while wearing them.

Let us consider some of the new hospitals that have been built under public-private partnerships. The design of the royal infirmary of Edinburgh is appalling. There are carpets right up to the doors of the wards—that is a hobbyhorse of mine—and they are not even very clean carpets. Going into the RIE, we might think that we are entering an airport terminal. There are restaurants and cafes—food is being eaten all over the place. That cannot be appropriate for our hospitals. There are unlimited visiting hours on communal wards. Heaven help someone who is feeling very ill when there are lots of families bouncing about. Children bounce about on beds with their dirty little feet from the dirty little streets. Outdoor clothing carries unseen germs. We carry them around with us and we take them into the wards that house the ill and the vulnerable.

How I remember the days—I am saying this because I am so old—when the hospital matron would allow two people in for only two yours. Heaven forfend if a visitor sat on the end of the bed rather than on one of the wipe-down chairs. Practices must change.

I very much welcome the cabinet secretary's remarks. I say to the families concerned that their pain and loss will continue but, as with all bereavements, it will ease with time—it will not go, but it will ease. However, I know that their anger will be assuaged only when we get to the bottom of the matter and get the full facts, and when we make Scotland's hospital wards and care homes safe and clean places for the people we put into them.

Patricia Ferguson (Labour, Glasgow Maryhill)

A number of colleagues are probably aware that I underwent surgery some months ago. Of course, I was aware of the debate around hospital-acquired infection, but I admit that that was the last thing on my mind as I cleared my desk and cancelled appointments. I wanted to get into hospital, have the surgery and recover as quickly as I could. It was only an e-mail exchange with a local general practitioner with whom I was working on a campaign that reminded me that avoiding infection was something else that I might have to contend with. The GP told me not to allow anyone—nurse or doctor—to examine me without first washing and gelling their hands and putting on gloves. She told me that they should change their aprons every time they approached a patient and every time they left a patient, too. She gave me a comprehensive list of dos and don'ts.

I remember wondering whether I would remember all those rules if I happened to be feeling particularly unwell. Would I have the courage to ask someone on whom I was relying for care to please wash their hands? I was fortunate, in that those who were caring for me were scrupulous in that and every other regard. However, on one occasion, I heard a young nurse reprimand a consultant who approached the patient in the bed next to me and told him in no uncertain terms that, although she was aware that the person was his patient, if he did not put gloves on he would not be examining any patient in that ward. The other patients in the ward resisted the temptation to applaud at that point. Should patients have to think like that, though? What of those patients who are too ill or too elderly, or who have problems communicating? Who will look out for them?

My treatment contrasted sharply with that received by an elderly constituent of mine. The lady in question went into hospital for a relatively minor operation and, having been discharged and readmitted, and discharged and readmitted again, she was eventually diagnosed as being infected with Clostridium difficile. Her family informed me that, unfortunately, they were never told that she had a C diff infection, nor were they aware that any particular infection controls were being used. A close family friend, herself a health professional, once had occasion to complain about the way in which sharps were being disposed of by a doctor, as well as about the attitude of staff who were asked about the patient's progress.

Unfortunately, the lady passed away. Some months later, because of the complaint that her family made, the death certificate is to be amended to show that Clostridium difficile was in fact a contributory factor. The family has received reassurance that the issues that they raised are being addressed in the hospital in question. In the meantime, however, a family has had to deal with anxiety for a wife and mother, and with a feeling of disbelief that our NHS could allow her to suffer in that way when she was vulnerable and afraid.

I posed the question earlier: what of the patients who are too ill or too elderly to help themselves? How are they to be protected? Their first defence must be the hospital or other health care staff, but we must give those staff the resources to allow them to do their job. Staff need to have information about how infections are caught and spread, and about the different ways of dealing with them. They need to know about the latest infection control methods, and they need the confidence to challenge others when they fail to follow the rules.

As I am sure we all agree, much has been done in recent years to tackle health care acquired infections but, if we are really serious about it, we have to adopt the 15-point plan and be flexible in the years ahead. Only through having a comprehensive plan for prevention and treatment will we ever be able to tackle the problem properly.

Reducing the number of cases of health care acquired infection needs to be our next big crusade. It should unite the chamber, not divide it. It should be tackled with the determination that previous generations brought to their efforts to control the spread of tuberculosis.

Ian McKee (Scottish National Party, Lothians)

The problem of how to deal with health care associated infections is one of the most intractable issues facing the health service. Since the turn of the century, the escalating figures for deaths from this cause show that it is a long-standing problem and not just one for the SNP Government. As the prefix "health care" suggests, HAI does not just affect hospital in-patients but extends its tentacles into the community, as thousands of women who get thrush after antibiotic treatment for urinary tract infections can readily testify.

During the years that I was in general practice, I frequently performed minor operations on my patients. I removed toenails, cysts, and lipomata, and I incised abscesses. Colleagues with more extensive surgical experience performed more exotic surgery. Rarely was there a wound infection, waiting lists were measured in weeks rather than months or years, and, with policy favouring a shift of care from the hospital to the community, we were all convinced that more surgery would be undertaken in the community.

What happened? Fear of the transmission of new variant Creutzfeldt-Jakob disease led to the Glennie report, which laid down strict guidelines for the facilities that were to be provided before surgery could be undertaken. Those guidelines were impossible to satisfy in many doctors' surgeries. Today, almost all people who would have undergone procedures locally are now referred to hospital, but in 2008 there was only one death from vCJD in the United Kingdom and five from CJD caused by health-related procedures. Patients who were formerly dealt with in the community to everyone's satisfaction are now being operated on in the accident and emergency departments of Scottish hospitals that, between July and September of last year alone, experienced 522 cases of MRSA infection, a condition that can be transmitted in accident and emergency departments as well as among in-patients. The law of unintended consequences strikes again.

Today's motion strongly emphasises Clostridium difficile infection as a source of HAI. Labour's 15-point action plan, although a little late on the scene from those who were in government when the number of Scottish deaths from C diff trebled, is an effort to get to grips with the problem. I do not decry that effort, although many of the suggestions are already being implemented. However, it is futile to have a target of a 50 per cent reduction in Clostridium difficile infection by 2011 unless a clear indication of how to reach that target is given. Although cleaner hospitals, better sterilisation procedures and a greater emphasis on hand washing can go some way towards meeting the target, the ability of C diff to form resistant spores means that those procedures are not always as effective as they would be for other HAIs.

Nanette Milne (Conservative, North East Scotland)

Given that many of the elderly patients who contract C difficile have difficulty with faecal continence, does the member agree that using containment measures to prevent soiling of bed linen and so on is an important factor in controlling infection?

Ian McKee (Scottish National Party, Lothians)

Absolutely. The point I am trying to make is that cleansing methods are not the whole answer in dealing with C diff, because it is a very resistant bacterium.

A 2008 article in the Journal of Antimicrobial Chemotherapy showed that increased usage of alcohol-based hand wipes in hospitals significantly diminished the incidence of MRSA but had no effect on the incidence of C diff. According to the Association of Medical Microbiologists, the sensible use of antibiotics in hospital is the key to the prevention and control of C diff, as Mary Scanlon has already told us. However, there is little mention of that in Labour's action plan. A broad-spectrum antibiotic may be used to control or prevent infection for one reason or another, but it might interfere with the normal bacterial flora of the gut, allowing C diff a space to multiply. Using antibiotics less in primary and secondary care, and using bacteria-specific rather than broad-spectrum antibiotics, should do a lot to reduce the incidence of C diff. Will that increase morbidity and mortality among those who are denied the antibiotics that traditionally have been used in their treatment? The truth is that we do not know, but it might. If it does, Opposition MSPs, whichever party they are in, will have another stick with which to beat the Government of the day. HAIs are not susceptible to easy solutions, so let us not pretend that they are.

Helen Eadie (Labour, Dunfermline East)

I apologise to members for missing one or two of the opening speeches because of today's traffic problems.

I welcome the opportunity to contribute to the debate, and am glad that we all agree that this is one of the most serious challenges facing the public. Everywhere I go, people agree that there is a crisis of confidence among the wider public on the issue that Patricia Ferguson spoke about so eloquently. We have seen the deaths in the Vale of Leven hospital, and the 90 deaths in Maidstone and Tunbridge Wells, where there were significant outbreaks. Following those outbreaks, the NHS on the south-east coast of England published the goals and priorities that it wants to deliver by April 2011. It pledges to have wiped out hospital-acquired MRSA by 2011 and reduced Clostridium difficile by 55 per cent.

We ask the Scottish Government to demonstrate a similar commitment in tackling health care acquired infections. The spin that accompanied the previous set of figures, which went against what Health Protection Scotland said, serves only to undermine public confidence in the figures. It is true to say that there was a fall in cases during the previous quarter, but there was an annual increase.

I am happy to join Jackie Baillie in thanking our academic professionals, whose diligence and commitment has shone a light on this vital issue for everyone in Scotland. I agree with others that we should pay tribute to Jackie Baillie, whose dogged determination has made such a mark in Scotland.

Later today, I will meet a number of my constituents who are following this debate, and we will talk about their reaction to it. I have worked with a number of them in recent times, and they or their relatives and loved ones have all been affected by hospital-acquired infections. Like members, they have raised the importance of what is recorded on death certificates. I have written to the cabinet secretary about that, and she has responded that she agrees that there is an issue and she plans to take action to address it. I look forward to seeing how that progresses.

I have also been in contact with a family that raised significant concerns about patient transfers. How can a patient leave one hospital, such as the Queen Margaret, where they have been told that they do not have a hospital-acquired infection, yet be told within an hour of arriving at another hospital, such as the Cameron hospital, that tests show they have C Difficile? That situation raises extreme concerns in families. The two brothers and sister who will be with me this morning have expressed profound concern about how one hospital can say that there is no infection while the other says that there is within one hour of the patient transferring.

Nanette Milne talked about hygiene and washing, which have been raised by a number of my constituents. When they arrive to take a patient's washing home, they are given it without being advised whether there is an outbreak on the wards. That is a matter of serious concern. Such washing should not be taken home; it should be washed properly within the hospital environment.

I welcome the submissions from various people across Scotland who have expressed their concerns. The Royal College of Nursing said that it has serious concerns about investment in the workforce, which needs to be increased. In preparing the budget in the past year, we saw a proposal to reduce the money for training, a point that I raised with the Health and Sport Committee and the cabinet secretary. In real terms, that money has gone down. Health boards need to employ more nurse epidemiologists, who provide expert advice on organisms that cause hospital-acquired infections and how to prevent them.

The resources that are available to the Scottish national reference laboratories should be assessed to establish whether they can analyse and monitor hospital-acquired infections in a timely manner that benefits patients. There might be new organisms that cause HAIs in future. The laboratories need to be equipped to deal with that, so resources should not be cut. More resources should be targeted at improving hospital isolation facilities to allow HAIs to be treated more effectively and to help prevent their spread.

I warmly welcome the consensus in the debate. I am tempted to support the Liberal Democrat amendment. As Jackie Baillie said, the Public Petitions Committee's unanimous view is that there should be a public inquiry into the outbreak at the Vale of Leven hospital. I understand that public inquiries are expensive but, in this instance, it is vital that we have one.

Alasdair Allan (Scottish National Party, Western Isles)

The tone of the debate has suggested that members do not doubt one another's sincerity on the need to tackle hospital-acquired infections. In that spirit, I commend the motives behind Cathy Jamieson's motion. Many members will have relatives or constituents who have been affected by hospital-acquired infections—I can think of some harrowing examples. However, in supporting the amendment in the name of the cabinet secretary, I bring to the Parliament's attention the work that NHS staff are already doing to tackle the problems. Nobody should underestimate the size of the task ahead, but neither should we overlook the work that is being done.

Mary Scanlon (Conservative, Highlands and Islands)

As the member represents the Western Isles, does he agree with the "NHSScotland National Cleaning Specification Monitoring Framework Independent Audit Report", which states that

"NHS Western Isles should be commended as a beacon site"

of best practice?

Alasdair Allan (Scottish National Party, Western Isles)

The Western Isles are, in every respect, a beacon, and I am happy to commend that particular example.

As I said, we should recognise the work that is being done. Nurses, doctors, health managers and, perhaps most important, cleaners have already made great progress. As Christine Grahame pointed out, between 2001 and 2006, the number of deaths in which C difficile was an underlying or contributory factor soared from 170 to 417. Such a massive increase requires dramatic action, and action is being taken that is paying dividends. The tragedy of a single death from a hospital-acquired infection renders all statistics redundant, but we should pay tribute to the health service in Scotland for reducing rates of hospital superbug infections to their lowest levels since records began in 2003.

Perhaps the most significant change of emphasis has been on the simple matter of hand hygiene. We have come a long way in the 100 years since an instruction went out to all doctors, particularly those dealing with infectious patients, to wash their hands before delivering a baby. It seems scarcely believable that such a reminder was required. No doubt it was resisted by some doctors at the time as an undue interference that called into question their clinical judgment. Patricia Ferguson's story about a consultant leaps to mind when I say that. That single measure 100 years ago resulted in a staggering decrease in mortalities among mothers and babies. Today, we cannot overestimate the enormous significance of improving the hand washing regime in hospitals in tackling superbugs. A zero-tolerance policy on hand hygiene has been announced and compliance is at the highest rate since records began—93 per cent, which exceeds the Government's targets.

That is one of the many ways in which the health service is already doing much of what the 15-point plan that is mentioned in the Labour motion calls for. I welcome the consensus that has emerged. Other measures include the HAI reporting template, which gives the public instant access to information on infection rates, and the plans for a care environment inspectorate. Further, there is the welcome news that all new-build hospitals will have 100 per cent single-room accommodation.

Jackie Baillie (Labour, Dumbarton)

Can the member possibly tell me when the entire estate of Scottish hospitals will have appropriate isolation facilities, using that single room analogy?

Alasdair Allan (Scottish National Party, Western Isles)

No one pretends that the entire hospital estate can be rebuilt overnight, but the Government has made it clear that we are moving towards 50 per cent provision in existing hospitals. Everyone accepts that, in the longer term, single rooms are the way forward.

Nobody underestimates the scale of the task, which is why the Scottish Government has released £3 million to promote further development of local surveillance systems and to prepare for the roll-out of the national MRSA screening programme. Perhaps one of the most significant changes will be the ending of the privatisation of cleaning services in hospitals. I hope that, once more, cleaning staff will begin to feel as though they are the valued workforce that they deserve to be and that they will be able to play their vital role in the fight against infection without forever having to look over their shoulder at a contracting system that has, in the past, worked against those very ends.

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

I acknowledge the evident sincerity with which all the speeches have been made. There is no doubt that the Parliament is united in the opinion that health care acquired infection must be tackled. Cathy Jamieson, for the Labour Party, spoke of patient confidence and patient safety—which are my themes, as they were for Ross Finnie—and how they also apply to care in the home, care homes and nursing homes. That is the extent of the problem. She correctly reminded us that the HAI task force was started by the previous Government and she mentioned the importance of isolation facilities.

The cabinet secretary, Nicola Sturgeon, spoke of addressing patient anxiety, which echoed Cathy Jamieson. She mentioned the role of the new care environment inspectorate, which should make a difference; the pilot MRSA screening programme; and the proposals to have only single rooms in new-build hospitals to provide isolation. She also mentioned Grampian NHS Board's electronic bed management scheme. It is important that we roll that out.

My colleague Ross Finnie said that the public feel quite sore about HAIs. He said that people want to go to hospital knowing that they are going to get well, not get worse. Like Ross Finnie, I acknowledge the work of the Labour Party in producing the 15-point plan, which is an extremely useful contribution. However, in the same breath, I am bound to acknowledge that, as Ross Finnie said, the cabinet secretary has undertaken to try to mesh the plan with the action that the Government is taking. That is a generous proposal and it should be accepted. That said, it behoves all parties in the Parliament to monitor the situation to find out whether that really happens. We must ensure that we have additionality and that as much as possible of the 15-point plan is taken up and used, when it is practical and sensible to do so.

Mary Scanlon made the hugely important point, on which I have commented previously in the Parliament, that patient pressure is linked to the prescribing of antibiotics. I have humorously referred to my dear mother, who keeps drugs long beyond the time that they should be kept. That is precisely the sort of issue that we are talking about. Jackie Baillie, on a chill note that was nevertheless accurate and true, reminded us that, as more toxic strains of Clostridium difficile and other superbugs come to the fore, the fight will be extremely difficult. Christine Grahame referred to dirty little children with their dirty little feet and to the issue of uniforms. Those matters are important. We must ensure that carpets in hospitals go only as far as they should go. I commend Patricia Ferguson for bringing her personal experience to the debate, which reminded us of the sheer importance of the issue. I acknowledge the contributions of Ian McKee, Helen Eadie and Alasdair Allan.

Our amendment states:

"given that the cabinet secretary has deemed the publication of the report of the independent review team on Clostridium difficile at Vale of Leven Hospital as not being prejudicial to the police inquiry, calls on the Scottish Government to establish a public inquiry immediately."

When I referred to Cathy Jamieson and the cabinet secretary, I talked about patient confidence and patient anxiety. The Liberal Democrats' point is that, if we are to maximise the patient confidence to which Ross Finnie referred, so that people know that they will get better and not worse by going into hospital, there must be public confidence in the light of proper examination of what went wrong. If the Lord Advocate tells us that a public inquiry would be prejudicial, we will heed that, but we have no evidence of that at this stage, so I ask members to support the amendment in Ross Finnie's name.

Jackson Carlaw (Conservative, West of Scotland)

I will start with a short story. Someone known to me recently underwent a third invasive procedure for a minor outpatient operation. When she was called back to hospital for the second procedure, under the national health service, she was somewhat bewilderingly asked whether she had brought any dressings with her, as the hospital had run out. It reminded me of the occasion when a plumber who was trying to unblock a sink in the house asked my wife whether we had a plunger. There are certain things that we expect people to have and which we take for granted they will have.

For her third operation, the woman chose to use the independent sector. The point that surprised me and her was that she was asked to go to hospital in advance of the operation because she was told that, having been treated in the NHS, there was a presumption that she would carry MRSA and they needed to establish whether that was the case. That is something that ought to give us all considerable cause for concern.

The Vale of Leven case, if it has done nothing else, has reinforced in the wider public consciousness a concern about health care acquired infection in the NHS that, if allowed to take root and become part of the common currency of people's concerns, will be very damaging to the long-term reputation of the NHS. Decisive action is being taken, but it must be effective.

I say to Jackie Baillie in particular, if I may, that the political cynic in me, if I can call it that, made me perhaps somewhat sour and ungracious in my initial reaction to the 15-point plan that the Labour Party introduced a few weeks ago. I was cornered by Jackie Baillie, who told me that if I did that again I was to be advised that she was coming for me. Colleagues on this side of the chamber told me that that was a threat or a challenge that I ought to take very seriously. My staff were encouraging me and were very excited at the prospect, but the measured and serious way in which Cathy Jamieson addressed the 15-point plan in her speech has allayed many of my concerns. However, I will state for the record what they were.

I would almost have been better convinced by a plan that had 14 or 19 points. The 15 points led me to think that the plan was somewhat contrived in its construction—partly because, earlier this week, the leader of the Labour Party had a 15-point plan for the economy, too. I was just slightly anxious about Labour having 15-point plans for everything, but that may have been an unreasonable attitude.

I also felt that there was no prioritisation in the 15-point plan. It seemed to me that some points had more substance than others and that it would have helped if they had been prioritised. I would also have welcomed it if the plan had spent a bit of time analysing the contribution that the Government has made in advancing a number of points in the plan and saying what progress has been made against them.

Jackie Baillie (Labour, Dumbarton)

Does the member accept that we were building on what is happening and that the 15-point plan was offered as a contribution to what more needs to be done?

Jackson Carlaw (Conservative, West of Scotland)

I think that I have done that. I accept that this is not a subject that any one party in the Parliament, conscious of the fact that there is now widespread public concern, is trying to address as a monopoly concern of its alone. Every party has a contribution to make. We have made a contribution in respect of the hospital bed management and acquired infection software, which is being piloted in Aberdeen—the health care acquired infection element is being done in Belford hospital. The software allows clinical staff, who have been involved in its design, to see exactly where outbreaks of infection have taken place and to ensure that they are properly monitored and that beds are cleaned thereafter.

Part of the problem with the current system is that a patient leaves a bed and it is sometimes established only post mortem that they had C diff, by which time nobody can remember which bed they were in and another patient has been put in it who subsequently becomes infected. The software will address that.

Our intention is to support the Scottish National Party amendment, which refers to the programme that we are progressing. Were that amendment not to succeed, we would be minded to support the Labour motion. We have a difficulty with the Liberal Democrats' amendment because we do not at this time support having a public inquiry.

Shona Robison (Scottish National Party, Dundee East)

This has been a far-reaching debate on an issue that impacts on us all. I am very grateful indeed for the constructive contributions that have been made on all sides of the chamber, which shows the seriousness with which the whole Parliament treats this important issue.

The cabinet secretary took some time in her opening speech to set out the actions that we are taking across the NHS in Scotland and I want to use a little bit of my time to restate the significance of those actions and how they impact across the NHS. NHS boards now have better local surveillance systems in place, which are more transparent, robust, sensitive and reliable in identifying situations that require further investigation. A far better understanding of the different C diff strains is emerging through the work of the C diff national reference laboratory, a more robust reporting regime is in place and there is a zero tolerance approach to non-compliance with hand hygiene standards.

I was struck, as I think other members in the chamber were, by Patricia Ferguson's description of the nurse pulling up the doctor. I think that that is absolutely right; it should be understood throughout the NHS that it is everybody's responsibility, no matter how senior the person who breaches the guidelines, to speak out. I say well done to the nurse who did that.

It is important to reiterate that we are investing record levels of resources in tackling HAI and increasing spend by £39 million over three years, which is a 260 per cent increase. We have announced a target, from April 2009, for NHS boards to reduce C diff rates by at least 30 per cent by March 2011, but we will ask boards to set themselves a more challenging target for reducing C diff year on year.

Jackie Baillie (Labour, Dumbarton)

There has been talk this morning about the Government agreeing to mesh the 15-point action plan in. Will the Government agree to implement all of the 15-point action plan? Specifically, will the Government commit to a target of a 50 per cent reduction in C diff by March 2011 for all ages from two upwards?

Shona Robison (Scottish National Party, Dundee East)

I was just coming on to talk about the 15-point action plan. We have confirmed our understanding that much of what is in the Labour Party's 15-point action plan—

Jackie Baillie (Labour, Dumbarton)

rose—

Shona Robison (Scottish National Party, Dundee East)

I will come on to Jackie Baillie's specific point if she just gives me a chance to do so.

Much of what is in the 15-point plan is already in place in Scotland in the 57-point action plan that is being actioned by the national HAI task force, which has been asked to review the detail and consider what actions would further enhance our already extensive HAI work programme. I can tell Jackie Baillie that it is on the agenda for the next meeting of the HAI task force on 24 February to take that work forward, so it is happening very quickly. I hope that that assures members across the chamber that the HAI task force will act on that very quickly indeed, as is quite right and proper.

It is also important to say that our rates of MRSA are now at their lowest since surveillance reporting began: C diff rates are down by 17 per cent on the previous quarter and by 2 per cent on the same quarter last year; and, of course, despite concerns that have been raised in the chamber about hand hygiene compliance, it is at its highest level—93 per cent—since reporting began, so that message is getting through to front-line staff in our health service. It is clear that only by continually improving and redoubling our efforts to tackle HAIs will we see those trends continue, so there is no room for complacency. Only by doing that will we give the public the necessary reassurance that they deserve.

Cathy Jamieson (Labour, Carrick, Cumnock and Doon Valley)

I want to follow up Jackie Baillie's point, particularly on the target. When it meets, will the task force consider whether to increase the target? Will the minister bring a report back to Parliament on that?

Shona Robison (Scottish National Party, Dundee East)

I thought that I had made it clear that the task force will consider all elements of the 15-point plan. None is excluded. The task force will look at the 15 points and advise what further progress needs to be made, including in relation to the target in the 15-point plan. I can give the member that reassurance.

Finally, members can be assured that our HAI work programme will continue to engage with a wide variety of agencies through the national task force, which is responsible for overseeing actions on reducing infection rates in Scotland. I am sure that members will welcome the fact that we are also engaging with many linked sources, including the patient safety and patient experience programmes.

Alasdair Morgan (Scottish National Party, South of Scotland)

The minister should wind up.

Shona Robison (Scottish National Party, Dundee East)

With Parliament's co-operation, I am sure that we can make the progress that everyone wants to see. I urge members to support the amendment in the name of Nicola Sturgeon to take that important work forward.

Richard Simpson (Labour, Mid Scotland and Fife)

This has been a good debate, so let me begin with some positives. We welcome the follow-up report to the independent review of the Vale of Leven outbreak, which makes it clear that substantial progress has been made. We welcome the changes to the HAI task force programme that the cabinet secretary has announced, particularly the hospital-by-hospital reporting and the new web portal.

Let me be clear that we in no way doubt the Government's concern about making progress on HAI generally. Indeed, we welcome the undoubted progress on MRSA that NHS staff have achieved even before the pilots have reported. Despite what Dr McKee implied, we do not suggest that it might be possible in future to eliminate all health care associated infections. Such a suggestion would be foolish, as that will not be possible. MRSA, C difficile, norovirus and vancomycin-resistant enterococci—which is another new infection on the horizon—will be with us, so they will need to be tackled effectively.

Our concern is that the current situation is not advancing quickly enough. For example, the cabinet secretary reminded us—quite rightly—of the substantial increase in funding that the Government has put into tackling HAIs, but that is mainly for the MRSA pilots, which will swallow a huge amount of the funding.

The recent Audit Scotland report highlighted a £512 million backlog in maintenance, which we need to deal with to tackle HAI infection. Hospitals with maintenance problems are more likely to have HAIs. Audit Scotland reported that PPP hospitals are well maintained, but all those other facilities need to be dealt with. For example, temperature-controlled and automatic washing basins are vital. Further to Alasdair Allan's comments, I point out that if people turn on the taps to wash their hands thoroughly and then need to turn the taps off, they will transfer the bacteria that they had put on the taps back on to their hands. We need modern facilities urgently.

Labour recognised that MRSA and C difficile were growing problems, as Christine Grahame mentioned. C difficile hardly existed 10 years ago. Previously, it was a commensal, largely non-symptomatic, organism. We recognised that C difficile had increased and, as it were, had come up on the rails, so we tried to draw together all the work on the issue by setting up a HAI task force in 2006, but items that were on the agenda of the task force's first meeting—the minutes of which I have read thoroughly—are still on the agenda today. For example, the dress code that is now being implemented was on the very first agenda. The Cairns Smith report identifies

"implementation of the NHS Dress Code"

as one of the issues that are still outstanding.

Christine Grahame (Scottish National Party, South of Scotland)

I am wondering where you were for eight years, when you were in government. You did nothing about the dress code then.

Alasdair Morgan (Scottish National Party, South of Scotland)

I remind members not to address each other in the second person.

Richard Simpson (Labour, Mid Scotland and Fife)

Christine Grahame has not listened to the point I have been making. We set up the HAI task force, which has been continued and has produced 56 points. Revised information and guidance on death associated with C difficile has been issued to medical practitioners. That was not an issue eight years ago, but it is an issue now.

Implementation of the outcome that we all want to achieve, which the HAI task force plan indicates, seems to be rather leisurely and slow in some places. The issue has not had the impetus that it is now being given following the tragic incident at the Vale of Leven hospital.

As my colleagues mentioned, the health service in England has met the target of a 30 per cent reduction in C difficile. In the south-east and in other regions, targets of 50 and 55 per cent are now being set. We need to revise our targets and to make progress.

I ask the cabinet secretary to be cautious in interpreting the statistics that are reported. In England, the health service has met its target of a reduction in C difficile on the whole of the previous year of 2007. In Scotland, we have not achieved a reduction in the rate of C difficile associated disease in the rate per bed occupancy, which is Health Protection Scotland's preferred measure. The rate increased in the two winter quarters but decreased in the two summer quarters. HPS said that that was a "seasonal variation", but the cabinet secretary's press releases said that the reduction was a trend. That might be the case, but there is no way of telling. Given that public confidence was undermined by the Vale of Leven situation, I urge the cabinet secretary to be cautious in interpreting the statistics.

Nicola Sturgeon (Scottish National Party, Glasgow Govan)

I absolutely agree with Richard Simpson. I ask him to review the Official Report of today's debate tomorrow morning, where he will see that I said that it is too early to determine whether the figures on C difficile represent a trend.

Richard Simpson (Labour, Mid Scotland and Fife)

I accept that entirely, but the cabinet secretary's press release called it a reduction. I just urge caution.

Do I have one minute left, cabinet secretary—I mean Presiding Officer—to conclude? [Laughter.] Sorry, all the promotions of the past week are getting to me.

I will finish by making a couple of serious points. First, we have an alphabet soup of organisations and systems. Their functions might be clear to the organisations themselves, but I can say as a doctor that it has taken me many days of work and many meetings with the individual organisations even to begin to comprehend their function and role. How can the public have clarity? We have HPS and HFS—health facilities Scotland—as well as NHS QIS, the care commission, health and safety at work, statistical process control, the SPORS reporting system, hand hygiene surveillance and even Audit Scotland. The system is too complex, so it needs to be simplified and focused. That is why we have recommended a single leader to help us achieve that focus. The Cairns Smith report that was published this week states:

"Restructuring ... has produced a much clearer and simpler structure, with clear lines of responsibility and accountability."

We need that nationally.

Presiding Officer, I realise that I should probably close now. This has been a good debate; members have drawn together a lot of serious issues and given some very good examples of their personal experiences and those of their constituents. Unless we draw together all the issues—hand washing, the environment, antibiotic policy, testing of toxins and death certification—and ensure that guidance is clear and standardised, we will not secure the public confidence that we all seek. I hope that the 15-point plan that we have produced will be seen as building on and complementing the 57 points that the HAI task force suggested. I hope that we will achieve that.

Let me make one last point. The public must be seen as our partners in this. Public involvement is taking place at a number of levels. In NHS Forth Valley, we now have members of the public on the team walking the wards—

Alasdair Morgan (Scottish National Party, South of Scotland)

The member must conclude.

Richard Simpson (Labour, Mid Scotland and Fife)

That is partnership.

Housing

Alasdair Morgan (Scottish National Party, South of Scotland)

The next item of business is a debate on motion S3M-3427, in the name of Mary Mulligan, on housing.

Mary Mulligan (Labour, Linlithgow)

If it is not too presumptuous, I shall start by congratulating Alex Neil on his appointment later today as communities minister. I hope that the Cabinet Secretary for Health and Wellbeing will not be offended if I say that I was disappointed to learn that Mr Neil will not open the debate on behalf of the Government today. I am sure that the new minister will bring a fresh approach to the huge challenges that housing is facing. I am also sure that if he listens to the many people who have a great deal of experience in housing issues—especially tenants and owners—he will realise that there are actions that the Government can take and I assure him that he will have the support of Labour members.

Unfortunately, the new minister comes to housing at a time of crisis. Those are not my words but the view expressed by the Scottish Federation of Housing Associations in its submission to the Local Government and Communities Committee yesterday. It is a view that the Scottish Government appears to share, as it has not sought to amend our motion.

One of the many ways in which we can witness the crisis is by looking at the number of houses that are being built. The Scottish National Party Government has pledged to build 35,000 houses a year, but in the first six months of last year just over 11,000 houses were built—and let us remember that that is before the full force of the credit crunch has hit. There has been a fall of 1,600 houses from the previous year. Even worse, included in that fall is a fall of 600 houses in the social rented sector. That is something that this Government is responsible for.

Before we hear the Government criticise the previous Scottish Executive for building only six council houses in the previous session, as the First Minister said recently, let us get some facts on the record. During the first two sessions of the Parliament, the actual number of homes for rent through housing associations was more than 30,000, and the 432 houses built by councils since the election in 2007 were planned prior to the election and were possible only because of the changes in housing finance that the Labour-led Scottish Executive introduced.

The number of houses that the Scottish Government is completing is falling. What will the Government do about it? One way in which the Scottish Government could reverse the fall would be by properly investing in housing associations. Housing associations have an excellent record on building new housing and renovating old stock, but the Government put that at risk by changing the housing association grant formula.

To be fair, I accept that the Scottish Government has taken action to try to get better value for the public pound, but the principle was wrong and the timing was absolutely wrong. I acknowledge that the cabinet secretary tried yesterday to reverse the damage—I suggest to the new minister that the cabinet secretary may be stealing a little of his thunder—but what she did was too little, too late. When ministers realised the damage that was being done, they should have reversed the changes and not just been satisfied with a half-hearted move.

Lenders were reluctant to lend under the new housing association grant formula, untested and riskier as it was. Only time will tell whether they will be more willing to lend after the limited change. It may be too late for some housing associations, which may already have agreed their development plans and rent levels for next year.

Having made one mistake, the cabinet secretary should not make another. I know that the proposals on the lead developer model are still out for consultation, but the measure is proving very unpopular. The cabinet secretary may do well to drop the proposal now. Johann Lamont will say more on the issue, but I want to say that I have no problem with housing associations working together—there are good examples of that across Scotland—but the competition that the proposal could introduce will not benefit housing associations or those in need of housing.

Yesterday at the Local Government and Communities Committee, members heard how progress to reach the 2012 homelessness target is stalling. Again, that is before the full effect of the credit crunch has set in. All the witnesses told the committee that increasing the supply of housing is essential. They also said that preventing homelessness is important.

Labour has welcomed the Scottish Government's recent announcements on extensions to the mortgage-to-rent scheme, and although we might be a little more sceptical about mortgage to shared equity we accept that it is yet another option for people in difficulty.

The cabinet secretary could be doing more. Why will she not follow the UK Government example for people who are facing court action? Last year, £10 million helped 160 households threatened with repossession, and the Scottish Government has said that there will be £15 million this year. That can perhaps help 200 or 300 households, but when the number of households that are facing repossession is rising towards 1,000 a month, is it really enough?

I will listen to what the Conservatives say about their amendment, but at this stage I am not sure that we can support it.

I acknowledge that the Scottish Government has brought forward £120 million—I welcome that—but we are very concerned about how slow it was to get the money out and working. So far, £35 million has been allocated, but only £10.5 million is actually to build homes. I understand that buying land at this time might mean a good deal, but additional funding will be needed to make the £12.8 million worth while—by actually building houses.

Serious doubts have been expressed about the £11.5 million for stock already built. We have yet to see any evidence that that was a good deal. It certainly does not do anything for the construction industry or unemployed builders.

Today, the cabinet secretary has an opportunity to show that she understands the challenges that face housing and that she has plans to tackle them. The number of repossessions is rising; the number of houses being built, in the public sector and in the private sector, is falling; and measures to tackle homelessness are stalling. I say to the cabinet secretary that it is now time for action.

I move,

That the Parliament notes the growing crisis in Scottish housing with rising numbers of repossessions, the continuing challenge of homelessness and the falling number of houses being built; calls on the Scottish Government to ensure the urgent and effective implementation of the accelerated spending programme, introduce a realistic housing association grant formula and negotiate with the housing association movement a range of flexible models of procurement, and further calls on the Scottish Government to examine, as a matter of urgency, alternative means of expediting the provision of land and infrastructure and the regeneration of communities.

Jamie McGrigor (Conservative, Highlands and Islands)

I, too, congratulate Alex Neil on his new position. I look forward to debating with him in the future.

The Scottish Conservatives welcome today's debate. We have been consistent in that we have opposed the SNP Government's decision to sanction a new generation of council houses. We continue to believe that what funding is available to build new social housing for rent in Scotland should go to our housing associations. Housing associations have demonstrated that they have the expertise and experience to create good new housing in sustainable mixed communities. Their record often stands in sharp contrast to that of councils. That is surely backed up by the recent second-stage stock transfer from the Glasgow Housing Association to smaller associations, which was voted for almost to a man and woman.

The SNP Government may be playing to its left-wing supporters by talking about taking over the mantle of John Wheatley, but I point out that, under the Conservative Government of Harold Macmillan, we built more council houses than almost anyone. However, those were different times; we do not now believe that that would be in the interest of people in Scotland who are waiting for a good-quality social home to rent. The people in former council houses in Glasgow have demonstrated by their votes that they prefer local housing associations.

Just for the record, in the past 25 years, the only year when more than 6,000 homes for rent were built by social landlords was 1995, under a Conservative Government.

I have listened to the concerns of housing associations about the negative impact that changes to the housing association grant are having on their ability to provide affordable homes. Indeed, on behalf of housing associations in the Highlands and Islands, I corresponded with the former minister repeatedly. It seems, judging by the cabinet secretary's announcements yesterday, that ministers have gone some way towards addressing some of the worries that exist—albeit at a very late stage for many housing associations, when many have already made financial decisions for the coming year, and for a temporary period only. I will be interested in the reaction of housing associations.

Our concern was to ensure that any changes in the HAG must result in more houses being built, not fewer, as seems to be the case. Ministers have yet to present a convincing case as to how housing associations will be able to find the estimated extra £5,000 or £6,000 private loan per unit—which they will still need even after yesterday's announcement—when the availability and costs of borrowing are more restricted and more expensive than when the changes were introduced.

I note the SFHA's concern that Scottish Government thinking is wrong to blame the housing associations for being inefficient developers and for rising HAG levels over the past five years when, in fact, housing associations, just like private developers, have had to deal with sharply rising land prices and higher construction costs. We always strive for efficiency and we welcome the void assumption being reduced from 2 per cent to 1 per cent, as we all want as few houses as possible to be empty, but we also understand that housing associations have to compete with the private sector for available land. Ministers need to work as closely as possible with the housing association sector to deliver the affordable housing units that we all want to see.

The housing association sector stands ready to help the Government deliver its housing targets, but it needs the appropriate support to do that. The briefing that I received from Construction Skills Scotland was extremely useful. I am glad that it is undertaking a detailed analysis of the house-building sector's skills and training requirements as well as planning reform.

As our amendment makes clear, we believe that any debate about the future of our social housing in Scotland must also consider stock transfer. David McLetchie will say more about that later in the debate. As I noted in December, the very high percentage of tenants in all five areas of Glasgow who voted in favour of second-stage transfer—83.8 per cent was the lowest figure and 95.2 per cent the highest—demonstrates the genuine public support that exists for locally accountable housing associations that are rooted in our communities. The local authorities that have gone through the stock transfer process are reaping the benefits while those that have not are generally seeing only minimal investment in their council housing stock.

At the time, the Minister for Communities and Sport welcomed the result of the second-stage transfer in Glasgow. Will the new minister and the cabinet secretary follow the logic and allow tenants from across Scotland to vote for first-stage transfer with all the benefit that comes from it? It is surely a no-brainer financially to see housing debt wiped out by the Treasury, and at a time of pressure on public expenditure—which the Cabinet Secretary for Finance and Sustainable Growth spoke about yesterday—most people in Scotland would expect their Government to pursue that with every effort.

I move amendment S3M-3427.1, to insert at end:

"; welcomes the second-stage stock transfer to local housing associations in Glasgow; notes that housing stock transfer in Scotland would achieve £2 billion of debt write-off from HM Treasury, and therefore urges the Scottish Government to engage proactively with the 26 local authorities yet to transfer their stock with a view to effecting stock transfers to community-based housing associations and facilitating further investment in affordable housing in Scotland."

Nicola Sturgeon (Scottish National Party, Glasgow Govan)

I thank Stewart Maxwell for his contribution over the past two years. Many of the achievements that I will talk about today are, in no small measure, down to his hard work and commitment. Subject to Parliament's approval later today, I am very much looking forward to working with Alex Neil who, I am sure, will carry on that good work and create plenty of thunder of his own.

We will support Labour's motion today because, thanks to Gordon Brown's mishandling of the economy, the number of repossessions is rising. In response, the Scottish Government is providing more help and advice and a £35 million home owners support fund.

Duncan McNeil (Labour, Greenock and Inverclyde)

Will the cabinet secretary take an intervention?

Nicola Sturgeon (Scottish National Party, Glasgow Govan)

Not just now.

Homelessness is still a challenge, which is why we are working so hard towards the 2012 target. The construction industry needs support, which is why we have accelerated £120 million of housing investment to this year and next year—twice as much, pro rata, as England. This year's allocation is fully committed and will support the building of more than 1,700 new homes throughout Scotland.

Johann Lamont (Labour, Glasgow Pollok)

Can the cabinet secretary tell us what proportion of the money that the Government has brought forward is being spent on supporting development rather than on land banking or on buying off-the-shelf housing that already exists?

Nicola Sturgeon (Scottish National Party, Glasgow Govan)

Most people who know anything about housing recognise and agree that the sensible way to use the money is to support new development, to give housing associations the opportunity to purchase land and to help the housing industry by buying, where appropriate, off-the-shelf units. That is what we were asked to support and what we are supporting. For all those reasons, we will accept the Labour motion.

Nevertheless, the motion is lacking: it lacks contrition and, to be frank, it lacks an apology. Labour's record on affordable housing was simply woeful. In the words of Iain Gray, Labour passed

"the best homelessness legislation in the world"—

which it did—

"but ... didn't build the housing to make it work."

How true. Labour promised to build 7,000 social houses for rent a year. However, during its 10 years in government, it completed on average fewer than half that number. I know that Labour members do not like to hear this, but in the last four years of the previous Administration, Labour managed to build a grand total of six council houses. So, we will take no lessons from Labour on housing.

Mary Mulligan (Labour, Linlithgow)

Will the cabinet secretary give way?

Nicola Sturgeon (Scottish National Party, Glasgow Govan)

I will not, just now.

I contrast that record with the record of the current Government. Yes—the total number of houses being built is falling due to the downturn in the private market. However, in the first year of this SNP Government, we started more public sector houses—including more social houses for rent—than had been started at any time since the early 1990s. Since we took office, more than 430 council houses have been started and our £25 million fund will deliver up to 1,000 more.

Mary Mulligan referred to the number of completions in 2007-08: the number of completions in that year was driven by the number of houses that Labour had started in the previous year. The number of new-build completions is projected to be higher this year than it was last year and we have, in addition, made clear our intention to end the right to buy for new-build social housing—an intention which has been shamefully opposed by Labour. All that is backed by funding that has risen by 19 per cent over the previous spending review and which will, in the next financial year, reach a record spend on affordable housing.

Of course, it is incumbent on us not just to spend more but to get more houses for our money, which is why we revised the HAG assumptions last year. We were right to do so. Nevertheless, the world has changed and we have listened, which is why yesterday we announced new assumptions that have been welcomed by the SFHA and described as a "considered response". That demonstrates that we are a listening Government. We will continue to listen during the consultation on investment reform.

We recognise that we live in difficult times, but we are committed to working with all partners to get through them. This Government will not only oversee the best homelessness legislation in the world, but will build the houses to make it work.

Ross Finnie (Liberal Democrat, West of Scotland)

I await the vote of Parliament before I extend congratulations to whomever might be the new housing minister. Nevertheless, I say in passing that we are looking forward to housing debates being conducted on a calmer, more measured and more considered basis. I think that I speak for the whole Parliament in saying that we look forward to that—although not with much hope.

This is an extraordinarily serious issue. As we all know, economic conditions have changed dramatically. Often, when economic circumstances change, we make decisions to pass off commitments or shuffle them to one side because they are further down the road and we think that that is the easier response. I am glad that, in the debate so far, there is an understanding that the homelessness target for 2012 must never be set aside simply because we face particularly difficult economic circumstances. We must not allow the people who are most affected by downturns in economic circumstances to become the victims of policy decisions that would make their position much worse.

The situation is extraordinarily complicated. Mary Mulligan was right to point to the very real dangers and difficulties that are emerging, particularly for people who are facing repossession. The mortgage to rent schemes and the variations on the mortgage to equity scheme that came about as a result of the recent report, which suggested improvements in those schemes, are a help, although like Mary Mulligan, I remain slightly sceptical about the suggestion that the existing legal protections will be sufficient to deal with the absolutely overwhelming increase in the number of repossessions.

The task that the motion sets us is to ensure that there is still a flow of houses becoming available on the market. I will make one observation on that, which I have made before. In reacting sensibly and responsibly to the current crisis, we should acknowledge that we are not trying to boost the availability of homes in order to recreate the market whose bubble has just burst. Rather, we are trying to build a market that recognises that some aspects of the previous model were much misguided. To that end, I hope that the emphasis in the private sector and among housing associations will be far more on building houses to rent than on building houses to buy. There is an urgent need to build a substantial rental sector in Scotland, taking into account the fact that the circumstances in the housing market will be very much changed for a long time.

I do not agree entirely with what Johann Lamont said in her intervention. The use of the £100 million to buy up land banks or houses is not necessarily a bad thing, provided that that money circulates round the housing market. It makes sense to enable those who are in the business to continue to develop housing, but it does not make sense to pay someone outside the market.

Johann Lamont (Labour, Glasgow Pollok)

I was making a serious point about the balance of spending. One reason why the money has been brought forward is to sustain the construction industry, but that particular spend will not do that. The building industry is concerned about that.

Ross Finnie (Liberal Democrat, West of Scotland)

I accept that proposition. The Government, in difficult and constrained times, has seriously to consider the amount of money that is available. I am pleased that the HAG formula has been adjusted, although Mary Mulligan is right to point to the continuing difficulties with it. There must be closer discussion between the Scottish Government, which is funding HAG, and the banking sector. If that money comes from the public purse, the Government and the banking sector must discuss how that sector can be assisted back into the market to facilitate housing associations' tackling of the issue.

I note that Jamie McGrigor's amendment is not entirely dissimilar to the amendment that he moved on 8 May last year and which, notwithstanding the reservations that Labour has expressed this morning, Labour supported. If we are going to try to inject more money into the system and ensure that there is a greater flow of cash—which seems to be the nub of the matter—the policy instruments that we are discussing appear to be fit for purpose. However, if we cannot facilitate that flow of funding, we will all be extremely disappointed. We will, therefore, support Jamie McGrigor's amendment.

Finally, I make one plea to the cabinet secretary. I know that the point that she makes sounds terribly clever, but I find it childish and churlish that she distinguishes a house that is built with public money by a housing association from a house that is built with public money that goes to a local council. To go on and on about only building six houses is churlish. The member is a far better cabinet secretary than that, and the remark is not worthy of her—I wish that she would drop it.

Alasdair Morgan (Scottish National Party, South of Scotland)

We move to the open debate. I can give members about five minutes each.

Hugh Henry (Labour, Paisley South)

If Parliament is disposed to sanction Alex Neil's appointment as minister, a gain for the ministerial team will be a loss for "Newsnight"—I am sure that the BBC is taking steps to plug the gap. One of the things that has unfortunately marked the housing debate over the past 18 months to two years has been a mixture of stubbornness and stupidity. Alex Neil is not known for stupidity, and I hope that he will bring his calming influence to change the stubborn attitude that has developed among his colleagues in the Administration.

The "Firm Foundations: The Future of Housing in Scotland" document would have been better titled "Building on Quicksand". It has managed to alienate and alarm the housing movement throughout Scotland, including people who are politically well disposed towards the SNP. They do not have a good word to say about the current housing policy.

I could make a number of political points, but the problem that faces the housing sector in Scotland is too important for that. We need some sort of movement and solution, and I would rather that we were able to persuade the Administration to admit that it has been wrong and that it will change. I welcome the slight shift that has been announced this week, but it is too little too late: the damage has been and is being done. The increase that was announced comes too late for many schemes—housing associations will have to revise projects to see whether they stack up.

The work is time consuming, and the unhelpful delays will further undermine the construction industry at a time when fast and decisive action could make a real difference in providing not only houses, but jobs throughout Scotland. Housing associations will still have funding problems even under the revised proposals. There will be a rise in private finance contributions, rents could go up by as much as 20 per cent in all the new-build developments and—worryingly—standards could fall. The maintenance of those developments could be affected simply because the money will have to be used to service increased loan-repayment charges.

Lenders are not offering favourable rates, if they are offering to lend money at all. Many are worried about the future viability of some housing associations because of what is going on. Why should housing associations use their own reserves to plug financial gaps? The Administration has ignored warnings from the housing movement. Reserves are built up over time from the rents of existing tenants, and are designated mainly for future maintenance of properties. Why should those reserves be used to subsidise new housing for future tenants?

Bob Doris (Scottish National Party, Glasgow)

Does Hugh Henry agree that the reserves estimates in previous HAG assumptions were wrong and that it was the input of new numbers that led to the revised HAG assumptions last year?

Hugh Henry (Labour, Paisley South)

Mr Doris might want to reflect on the matter and to talk to housing associations about how what happened previously pertains to what is happening now. Housing associations would appeal to return to the levels that were previously available. The Administration needs to revert to the HAG assumptions that were used in the previous financial year to kick-start affordable house building programmes in Scotland. It needs to use the expertise of housing associations, which I think members agree have a proven track record throughout Scotland.

I appeal to ministers to abandon the idea of a lead developer. That model has failed in England, and there is no evidence in the document that any cost savings will be made or that the model has worked elsewhere. Lead developers are just another level of bureaucracy that could cost more money to set up than would be generated in savings. The problem with the rhetoric over the past 18 months or so has been, as Ross Finnie suggested, that it has created an artificial division between council housing and houses that are provided and built by housing associations. I worry that that rhetoric has sought to downplay—if not to undermine—the role of housing associations.

Housing associations in Scotland have proved themselves: it is time for the Government to undo the damage, ditch the dogma and admit that it has got it wrong.

Sandra White (Scottish National Party, Glasgow)

I thank Stewart Maxwell for the work that he did during his term as housing minister, especially the work that he has undertaken with the Glasgow Housing Association, which has been very important to the people of Glasgow. I look forward to working with my new colleague if the motion is passed tonight, as I am sure it will be.

The Government has taken steps to increase substantially the position and the provision of social and affordable housing, for which I applaud it. Other members—the cabinet secretary in particular—have mentioned that under this Government more houses have been built, although I will not repeat all the figures. The right to buy that Labour extended to housing associations has been abolished by this Government. Labour applauds those housing associations, and yet it extended the right to buy to include them.

It is a great pity that Mary Mulligan and the Labour Party cannot acknowledge the fact that this Government has, in less than two short years, continued to put in more money and to listen to housing associations. Housing is an important issue, so it is a shame that the Labour Party is, once again, using it as a political football. We should all unite to rid this country of homelessness. It is about time the Labour Party acknowledged that and listened to what the Government has been doing.

Hugh Henry (Labour, Paisley South)

Will the member take an intervention?

Sandra White (Scottish National Party, Glasgow)

I do not have much time, but I will let Hugh Henry in shortly.

The Labour motion mentions the urgent need to examine

"the provision of land and ... the regeneration of communities",

which is an important point. If those issues are to be tackled, joined-up thinking involving local councils, central Government and housing associations will be necessary. The new planning legislation that is being considered should help in that regard. I sincerely hope that the forthcoming Commonwealth games will ensure that the much-needed regeneration of the east end of Glasgow goes ahead.

Hugh Henry (Labour, Paisley South)

Sandra White's criticism of the Labour Party is misplaced because we are only reflecting the fears and concerns of housing associations across Scotland. Those worries are being expressed not by us but by the SNP's partners in the housing movement in Scotland. The SNP needs to listen to them.

Sandra White (Scottish National Party, Glasgow)

I have met them and listened to them. I am critical of the Labour Party because it denies that, over the past two years, the SNP Government has done the work that it failed to do over the previous eight years. Labour members should bow their heads in shame, because Labour did nothing on housing. Only the SNP has spoken to the housing associations and addressed the issues that they have raised. Credit should be given where credit is due—that is my point.

Jamie McGrigor's amendment deals with second-stage stock transfer. I mentioned Stewart Maxwell's work with the GHA, which has been extremely important to the people of Glasgow. I have some facts and figures for Jamie McGrigor, to add to those that the cabinet secretary gave. Second-stage transfer is important and will be welcomed in Glasgow, provided that it is supported by the tenants and the housing associations can get a good deal from the GHA. We have learned lessons; people should look at what is happening with second-stage transfer in Glasgow.

I agree with Hugh Henry in one respect—we should reconsider the lead developer model. It might be a bit tricky having one main developer, particularly when it comes to second-stage transfer, so that needs to be examined.

I welcome the increase in HAG funds, which I am sure will help with second-stage transfer in Glasgow, but I caution against their use by the GHA to increase the price of each unit and I seek an assurance that that will not happen.

The road to second-stage transfer has not been an easy one and I understand that some housing associations are still waiting for valuations from the GHA, even though the cut-off point is 30 March. That is worrying, and I ask for ministerial clarification on that. Second-stage transfer in Glasgow has at times been difficult, so I applaud Stewart Maxwell for meeting the GHA to try to iron out the problems. Second-stage transfer to small housing associations is welcome and represents a benefit to the community. I hope that the lessons that we have learned in Glasgow will be learned by other parts of the country that proceed with second-stage transfer.

I welcome the debate. Housing is an extremely important issue. We must get it right, not just for homeless people, but for people who live in houses that are deemed to be unfit for habitation. I look forward to my questions being answered. Perhaps the Minister for Transport, Infrastructure and Climate Change can tell us about regeneration and land banking, which Johann Lamont mentioned. We must get best value and we must ensure that the people of Scotland have decent housing. Second-stage transfer must go ahead, but only if the tenants want it, and not at just any price.

Rhoda Grant (Labour, Highlands and Islands)

As an MSP for the Highlands and Islands, I cannot but be aware of the challenges that are faced in providing affordable housing in rural areas. There are no economies of scale; indeed, we would not want building on a large scale, as that would have a disproportionate effect on a small community.

However, it is vital that people have access to affordable housing. House prices on the open market are often well beyond the means of people in my area, who tend to have to have several jobs, some of which are seasonal and few of which provide the stable income that is required to enable them to borrow privately. We must set against that the fact that the area is sought after by folk who want to buy second homes or who want to move in from other areas. As such people tend to have comparatively large amounts of capital, they often outbid locals.

People should be enabled to live in the communities that they were brought up in and should not be forced out. Only yesterday, there was a story in The Press and Journal about a young family from Portmahomack whose private rented lease is coming to an end. Although they cannot afford to buy in the village, they cannot based solely on their local connections be guaranteed one of the nine new Albyn houses that are being built there. They face uprooting their family, moving their children out of school and moving elsewhere. However, we should not become so parochial that no one can move into rural areas. More affordable housing provides the answer to the problem.

From speaking to housing associations in my area, I know that the announcement that was made ahead of the debate—that the housing association grant will be increased by an average of 6 per cent will be welcomed—but that increase will not affect their ability to deliver small developments. The cost of building is much higher in rural areas because of the lack of economies of scale and because of the higher costs of land and of providing water, electricity and other services to developments. That means that rural housing associations will continue to need to apply for additional HAG money.

Such additional funding normally comes with conditions. The Government imposes a higher rent level on properties that receive it. I have mentioned the work patterns in smaller communities, which mean that those higher rents cannot be passed on to tenants because they are unaffordable, with the result that the whole funding equation falls apart because the assumed rent is higher than the actual rent. As it is the actual rent that is borrowed against, there will always be a funding gap between the HAG level and the mortgage on the property. For example, on a house that costs about £125,000 to build, the rental income is £2,800 per annum. The funding gap for that property alone is £7,500. Small rural housing associations cannot afford to finance such gaps, so they cannot afford to build.

If the Government is to allow small rural housing associations to build, it must stop imposing unaffordable rent levels in such communities. Housing associations know their tenants and they know what rent level is affordable in their area, so they are the right people to set a fair rent that takes into account local circumstances. Many of the housing associations in my area tell me that they cannot build under the present regime, which needs to change. Although HAG rises are welcome, the real problem is the imposition of rent levels. That is without taking into account the effect of the credit crunch, which means that a mortgage that was available under the previous rent assumptions might no longer be available. Something needs to be done.

As regards lead developers, I can understand why people might want them, given some of the benefits that they could bring but, unfortunately, we are not working with the right model. I ask the minister to consider the model that has been adopted by the Highland Housing Alliance, which brings all the benefits of a lead developer without causing competition among housing associations. The HHA brings together housing associations, councils and private developers to ensure that development is unblocked and that more housing is developed at efficient costing levels.

As a representative of remote and rural communities, the most important issue for me is that the Government should stop imposing rent assumptions in cases in which additional HAG is provided. That practice must change if much-needed housing is to be provided in such communities. The impact on the public purse would be small, but the impact on the number of affordable houses that could be built in rural areas would be huge.

Bob Doris (Scottish National Party, Glasgow)

I begin by paying tribute to Stewart Maxwell for all his hard work and commitment as housing minister, for which I thank him. In addition, I congratulate Alex Neil on the new post to which he will, we anticipate, be appointed this afternoon.

I genuinely welcome the Labour motion. Repossessions are a growing and significant problem, and I am glad that the motion acknowledges that. I also welcome the tone of the language that the motion uses in relation to the housing association grant, even if it has not been reflected in Labour members' speeches—although Rhoda Grant's speech was excellent. If time allows, I will return to HAG later.

I hope that we can build a consensus on repossessions. Members will know that I have talked regularly about my massive concerns about private companies offering sell and rent back products. In doing so, I have echoed the serious concerns of the Office of Fair Trading, which has called on the UK Government to regulate the practice via the Financial Services Authority. The Office of Fair Trading has evidence that companies that offer such products significantly undervalue the houses of struggling home owners at the very time when they must count every penny and are becoming increasingly resigned to having to sell their homes in order to tackle mounting debt. The last thing they need is property cowboys robbing them blind by giving them far too little cash for the property that they are being forced to sell.

Of course, the one benefit that families that are forced to sell their homes are supposed to derive is that they can stay in the family property. However, we have seen that that is not always the case, because rent level and security of tenure guarantees are often undermined and people are lied to or misled. The OFT found that that has happened. We hope that the UK Government will very soon regulate the shocking black market in repossessions, which results in pain, heartache and injustice for victims. I received a "wait and see" reply when I wrote to the UK Government on the matter. It is genuinely still considering regulation, which I expect will be introduced shortly. The Scottish Government is also pressing for regulation.

I am a member of the Local Government and Communities Committee. At its meeting this week, the SFHA and Shelter agreed with me that regulation is needed and that such repossessions put pressure on councils and housing associations throughout Scotland in respect of their meeting housing need and homelessness targets for 2012. The Labour committee members also agreed that movement is needed. I think that genuine cross-party support exists in the chamber to work with the UK Government on that.

Mary Mulligan (Labour, Linlithgow)

Given that nobody could see any benefits of the scheme in question, does the member agree with the suggestion that my colleague Patricia Ferguson made that simply abolishing it might be more productive?

Bob Doris (Scottish National Party, Glasgow)

I thank Mary Mulligan for her constructive intervention. I listened with interest to what was said during the meeting, and my immediate reaction was that the scheme should be abolished. On that level, I agree with Patricia Ferguson, but I am not sure how someone's ability to sell their house to a third party can be abolished without infringing their individual rights. However, I am interested in the UK Government's proposals. All options are on the table. Let us hope that we get the matter resolved very soon.

I have met the SFHA and housing associations throughout Scotland to discuss HAG levels—as other members have—and it is clear to me that there were two core elements to the call for HAG level adjustments. Our discussions on that were useful, as I think the Government's discussions with those bodies were. My understanding is that the Government has been clear about ensuring that the assumptions that have been used to calculate HAG levels are accurate. The formula was not an issue; the aim was to ensure that the figures in it were accurate. In working out subsidies, under the old HAG assumptions the figures for rent levels, uncollected rent, inflation levels, housing association reserves and so on were not accurate, which led to the revisions for 2008-09. I am delighted that we have a Scottish Government that has moved quickly and confidently to revise HAG levels for 2009-10 in the light of changed circumstances. If the numbers change, the subsidy will change. That gets to the crux of the matter. It is up to members to move forward with cross-party consensus to support local authorities and the housing association movement.

I am not sure how much time I have left. The Presiding Officer has indicated that I can keep on talking, so I will do so. It is not often that she indicates that I can do that.

I want to mention one or two other things that I am proud of. I am proud of the end of the right to buy new-build properties. That is a core issue.

There has been a lot of heat around the issue of six new council houses being built under the previous Administration. We can argue about the numbers as much as we like, but how can local authorities be incentivised to build new council houses if those houses will simply be bought under the right to buy? That approach must end, and we must incentivise local authorities to get back in the market to build affordable social housing. I am delighted that 1,000 or so such houses will come online as a result of a £25 million investment. I hope that they will do so soon.

I thank the Presiding Officer for her patience, and am glad to have taken part in the debate.

Johann Lamont (Labour, Glasgow Pollok)

I welcome the opportunity to speak in this important debate, although we are necessarily constrained by time. I hope that whoever is appointed as the new housing minister after 5 o'clock this evening will reflect on having a full debate in the chamber on the important subject of housing.

It is important for members to discuss housing and to end the Government's obsession with assertion over action. If ever there was an example of government by alibi, it was Nicola Sturgeon's speech. She talked about what everybody else's responsibilities are and wilfully refused to reflect on her own policy, "Firm Foundations". I hope that she listened to what Ross Finnie said about the six council houses, particularly as her Government has emphasised the continuing and critical role of housing associations in its policy.

The power of the threat of a Labour debate on housing is remarkable: there has been half a U-turn on a key policy on HAG spending. Given the absolute certainty about previous HAG assumptions, perhaps the minister could clarify what consultation took place with the housing sector on the new assumptions. I fear that they may have been plucked out of the air in a panic. Two Mondays ago, the then housing minister, Stewart Maxwell—to whom I pay tribute; I have enjoyed debating with him—stated that the grant formula was costing housing associations an extra £10,000 per house, but that that could be tackled by using reserves or borrowing. Four days later, the Cabinet Secretary for Health and Wellbeing announced that the issue was being revisited. Poor Mr Maxwell. He gallantly defended the Scottish National Party's policy while both the policy's demise and his own were being plotted.

The Parliament has already agreed that the Scottish Government's housing policy is seriously flawed. Despite that, the Scottish Government persists with it. Cuts in HAG levels will lead to rent increases or increased borrowing at the worst possible time, and the introduction of a lead developer model can be seen as undermining entirely the critical role of community-based housing associations. Are we to assume that the cabinet secretary, in supporting our motion and agreeing that there should be flexibility on procurement, is finally burying the lead developer role? Will she confirm that, given the GHA's role as a transitional body, its aspiration to be a lead developer will simply not be allowed to be fulfilled?

The problem with the firm foundations approach is that if the Scottish Government persists with it, it will seriously undermine the role of community-controlled housing associations. The approach is predicated on an assumption that housing associations have been feather-bedded in some ways. Reserves are talked about, but the reality is that they are used to plan not two years ahead, but five, 10, 15 and 20 years in advance. The very thing that sustained housing associations at a time when council houses were falling into disrepair because they had been starved of investment is now being used inappropriately.

There is talk of economies of scale. We know the pressures of diseconomies of scale. A big organisation spends without thinking. We need to reassert the importance of housing associations in community regeneration and in sustaining local communities. The Scottish Government must listen to those who tell it that such an approach will strengthen the role of the national housing associations at the expense of local housing associations.

The cabinet secretary must back off. In particular, in summing up, she should address a key point about the implications of the lead developer role that has been raised with me. The lead developer proposals would not allow charities—which the vast majority of the housing associations are—to undertake such a role. Things would need to be changed to allow subsidiaries to do that. Subsidiaries will not be registered social landlords, so they will not be able to receive HAG, which will then go to end users. The reason for the proposal in the first place—to give all the resources to a one-stop shop of regional experts—would be undermined, European procurement rules would apply to the procurement of the lead developer and things would have to be opened up to the private sector. Surely that is not the Government's intention.

We should apply the Swinney test to that policy, bearing it in mind that destroying community-controlled housing associations was not in the SNP's manifesto. The Parliament has voted against the policy and times have changed. The worrying conclusion that we have to draw is that the reason why we shall not get the cabinet secretary to admit that she is wrong—and she is—and the reason why she will not dump the policy along with the local income tax, is that it does not require parliamentary endorsement. The Scottish Government will persist with the policy not because it is right, but because it can. That is the approach of the pre-1999 Scottish Office and its administrative devolution for ministers, rather than that of a Scottish Government that is accountable to Parliament and, through it, to all those who are highly exercised and concerned about the current approach. We all agree that we are in challenging, fast-changing and difficult times, but the test of Government is whether it makes the situation better or worse. This Scottish Government currently fails that test in relation to housing and the sustainability of social rented housing at community level. It is time for the cabinet secretary to recognise that graciously, think again, dump the "Firm Foundations" document and policy—which the Parliament has opposed—and work with housing associations, MSPs and those in the housing sector to develop a housing policy that will make a difference to our communities.

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

I put on record my personal thanks to Stewart Maxwell, whom I have shadowed. We had a cordial relationship—the relationship between Government and Opposition spokesmen is one of the better things that we do here—and I am grateful for that.

I look forward to the probable, or possibly probable, appointment of Alex Neil as Stewart Maxwell's successor this afternoon. Despite the fact that he brings what I might call a whiff of brimstone to the job, it will not stop me from engaging with him warmly at all times, although possibly while wearing asbestos gloves.

Mary Mulligan referred to a time of crisis. I state the bindingly obvious: when we go through our post bags and do our constituency work, it is evident that the number of problems that people encounter when seeking houses, new builds or becoming homeless is increasing all the time. I link that with a point that Rhoda Grant made. In my constituency, Portmahomach is an area of housing pressure, as is Dornoch where a lot of wealthy people live. Getting affordable housing there is not easy and the same applies to the west coast of my constituency and some of the remotest locations.

Ross Finnie's point about the redundancy of the six houses argument is well made because we must look at housing in the round. Jamie McGrigor made a pro-housing association speech, but I suggest that he went a little too far in castigating Scotland's local authorities. When I think back to my time as a member of a housing authority, I remain proud of what we achieved on the ground in providing homes to people who needed them in the Highlands. Years on, those houses are still recognised as being well built and are very much sought after. Sadly, they were also the subject of the first right-to-buy applications. I say to Jamie McGrigor that there is a role for local government and housing associations to work together on land use. Rhoda Grant referred to Albyn Housing Society in the Highlands, which has been successful in working with Highland Council to develop land in a way that the council could not do itself.

My colleague Ross Finnie rightly reminded us that we absolutely must not take our eye off the homelessness target because to miss it would be to let down those people for whom we must work hardest. Ross Finnie also said something to which we will both probably return: there is a place for socially responsible private-sector landlords. There is also a role for local government and, although it is not appropriate for today's debate, if we think back to the powers of district councils in the 1980s and early 1990s, we will remember that there was engagement with the private sector that was productive in housing people.

I refer to Rhoda Grant again and compliment her on her speech. Nicola Sturgeon referred to the £120 million accelerated housing intervention fund. Referring again to my constituency, I hope that the money will be spread throughout Scotland and reach some of its remotest parts.

It would be wrong of me not to refer to the crisis that we are all aware is hitting the building trade. Every such business is feeling the pinch. New housing developments that do not go ahead, or that slow down, hit those businesses hard. I have had many representations from businesses in my constituency in the very far north of Scotland that are feeling the pinch. If that trend is allowed to continue, what will happen? We will see businesses folding, which will make it harder still to return to house building when times are better.

I say to the new minister, who might or might not be Mr Alex Neil, that if he will engage with the problems of the building trade, which are fundamentally wrapped up in building houses, that will be useful and constructive work. I conclude my remarks there, only five seconds over my time.

David McLetchie (Conservative, Edinburgh Pentlands)

I welcome today's debate on housing and the measured terms in which the Labour motion is framed. I also welcome Nicola Sturgeon's boast that the SNP Government is at last matching the housing achievements of the Conservative Government in the 1990s—a Government that, as we know, did more to make housing affordable for the working people of this country than any other in the history of our nation.

The Government is right to say that we need to maximise value for the taxpayer contribution, by way of the housing association grant, to the building of new social housing for rent. However, it would have been foolish to ignore the concerns raised by housing associations throughout Scotland that the proposed changes would have a negative impact on their development plans. We should welcome Nicola Sturgeon's announcement yesterday of the increase in HAG levels. Despite all that is said about new council house building, the fact is that the Government's plans in that area are so modest and tokenistic that housing associations will be responsible for building 90 per cent of the new social housing in Scotland for the foreseeable future. They need to be backed in that task.

I acknowledge that the use of lead developers is designed to maximise value for the taxpayer and the prospective tenant, but I wonder whether a lead developer model is necessarily the best model for every area. Creating a local development monopoly strikes me as anticompetitive, a situation which, in the long term, normally drives prices up, not down, by comparison with a more open market. The Government should not be dogmatic in that respect.

Our amendment focuses once again on housing stock transfer and we make no apologies for it. I welcome the support expressed by Ross Finnie, but I am somewhat surprised that Mary Mulligan was more equivocal, given that we are no more than stating the housing policy of the previous Scottish Executive.

It seems extraordinary to us on this side of the chamber that, at a time when it is constantly warning of the impact of forthcoming cuts to Scotland's block grant from the Treasury, the SNP Government should wilfully turn a blind eye to the £2 billion that the Treasury has put on the table to wipe out the accumulated housing debt of local authorities, in return for them transferring their stock to community-based associations. It is all very well for SNP ministers to welcome the partial implementation of second-stage transfer from Glasgow Housing Association to community-based housing associations, but that does not go far enough. It does not disguise the fact that up until 2007 the SNP was hostile to the whole concept of stock transfer and, since coming into Government, it has been pathetically passive. Time and again we have invited ministers to take a more proactive role with councils to facilitate transfers, achieve write-off and leverage in additional investment but, time and again, SNP ministers have refused to act, notwithstanding the need for affordable housing, which is particularly acute in this city.

Because of financial constraints, building a few council houses here and there is not the answer, whereas stock transfer could unlock a significant investment that would make a real difference. I hope that the new housing minister, who could never be described as pathetically passive while sitting on the back benches, will bring some of his brio and dynamism to the brief and look again at stock transfer to see whether we can bring about real change. If Parliament agrees to our amendment, it will be the green light that the new minister needs to take a fresh look at the matter. That is why members should support it.

Stewart Stevenson (Scottish National Party, Banff and Buchan)

My participation in the debate in no way adumbrates a change in my responsibilities, but it allows me to talk about land provision and infrastructure, to which the last part of the motion refers. In the five minutes that I have, I will try to deal with as many members' points as possible with brio and dynamism.

First, I will make a general point. The first law of epigenetics is that the more highly optimised an organism is for one environment, the more adversely it is affected by a change in that environment. The point is that taking a diverse approach has an intrinsic value. That is precisely why we disagree with and do not sign up to Jamie McGrigor's comment that there is no place for council housing. Of course there is a place for council housing, as part of the diverse housing provision that is necessary to meet our needs.

It is worth noting that the nature of housing tenure is not necessarily linked to how nations work. Twenty years ago, among the countries that now form the EU 27, the country with the highest proportion of rented accommodation was Germany and the country with the highest proportion of owner-occupied property was Bulgaria. Therefore, even with political systems and political leadership, diversity is significant.

Money has—of course—been a thread that has run through much of the debate. Yes—money is difficult to obtain for the Government, for housing associations and for businesses. That is precisely why it is important that the Government has put money on the table to help with cash flow for companies that have unsold stock, for example. This year, we have put in place £35 million of accelerated funding. Of that, £10.235 million is for construction, to deliver 716 new homes, and £12.72 million is for land purchase. When the former Minister for Communities and Sport and I visited the Irish Government a couple of weeks ago, we found that land purchase has been the key to that Government's ability to engage in many housing developments and in economic development. Land banks give Governments something to bring to the table. The accelerated funding also includes £12.11 million to secure 204 unsold new properties. In total, 1,700 new homes will be supported. More fundamental is the fact that cash will flow back into the system, which will make a real difference.

Ross Finnie chided us somewhat for talking about the low number of council houses that the previous Administration built, so I will say nothing about that. However, by excluding council houses from the way forward and saying that his party will support the Tory amendment, he makes a grosser error than he thinks that we made by focusing on the low number of houses that were built. I urge him to think more carefully.

Rhoda Grant made a good point about difficulties in rural areas because of incomers outbidding locals. We recognise those difficulties, which are the reason why diversity and more affordable housing are needed.

Lead developers have been a thread in the debate. The consultation is still in progress. Rhoda Grant said that she had suggestions—let us hear them and we will of course consider them.

In a pretty standard speech, Johann Lamont agreed with many of the Government's arguments yet managed to express her points in a way that suggested otherwise. I will ignore that. However, she made one good point that is worth exploring—that about the tension between economies and diseconomies of scale. Of course room exists for big and efficient national organisations. However, we also need organisations that respond to local needs and are connected to local people. We must achieve the right balance, because that tension exists.

Johann Lamont (Labour, Glasgow Pollok)

Will the minister give way?

Stewart Stevenson (Scottish National Party, Banff and Buchan)

I am sorry—I am almost out of time.

The Government is—undoubtedly—responsible and reliable. We are resilient in the face of change and responsive to change. I am happy to support everything that my colleague Nicola Sturgeon said and, of course, we will support the Labour Party at 5 o'clock.

Mary Mulligan (Labour, Linlithgow)

The debate has been good. It is clear that most members agree with the Labour group and housing organisations that housing is in crisis and that the Scottish Government needs to up its game.

First, I will address a couple of linked issues that I did not have time to mention in my opening speech. Labour's motion calls on the Government to respond to the recommendation of the housing supply task force, which reported last Friday, that it should

"examine, as a matter of urgency, alternative means of expediting the provision of land and infrastructure and the regeneration of communities."

I acknowledge the positive contribution that all members of the task force made. The task force's report considers the role of public sector land and asks the Government to consider new models for financing infrastructure. That is particularly relevant when private housing developments, whose developers contributed to infrastructure under section 75 agreements, have been put on hold.

Both those issues could be addressed through a nationally co-ordinated approach along the lines of that of the UK Homes and Communities Agency. Perhaps the Scottish Government's abolition of Communities Scotland was premature.

I will respond to points that were made in the debate. The Conservatives' amendment refers to stock transfer. We welcome second-stage stock transfer in Glasgow to local housing associations, but the amendment is too prescriptive. Not all local authorities carry significant housing debt, so why would they all want to transfer their housing stock? Labour sees the benefits of stock transfer, but its use must be decided case by case and local tenants must have the final say.

David McLetchie (Conservative, Edinburgh Pentlands)

The amendment is not prescriptive or dogmatic; its purpose is simply to ask the Government to engage more proactively with local authorities. Ultimately, deciding whether to proceed is a matter for each tenant area.

Mary Mulligan (Labour, Linlithgow)

I am not sure whether that is what the amendment says.

Mr McGrigor did not make many friends with his speech when, as Jamie Stone said, he criticised council housing. Many councils struggled to maintain their stock when the Tory Government squeezed and restricted their funding. Labour will support all those who seek to build affordable rented housing, whether they are housing associations or councils, where that is appropriate.

Jamie McGrigor (Conservative, Highlands and Islands)

Will the member give way?

Mary Mulligan (Labour, Linlithgow)

I am sorry; I do not have time.

Many members, including Rhoda Grant, Hugh Henry and Ross Finnie, mentioned the problems with operating the housing association grant formula. I am sure that the cabinet secretary listened to members' concerns and that she will recognise that she needs to go further than her announcement yesterday.

Members around the chamber opposed lead developer status—my colleague Johann Lamont ably underlined that. Perhaps the cabinet secretary could do another U-turn and reverse her position.

As I said, the debate was intended to highlight the housing crisis and urge the Scottish Government to do something about it. Outside the Parliament today, we are being lobbied by the Scottish Trades Union Congress, which is supported by the Scottish Tenants Organisation and other housing concerns. They are not standing in the snow for the fun of it; they do so because they have concerns about the state of housing. Their concerns are that housing need is not being met and that jobs are being lost in the construction industry. Like members, they want the Scottish Government to take action.

I understand that £120 million has been brought forward. However, people are concerned that the Government has been slow to spend that money, does not really know what to do with it and is sticking to house building targets that were set before the money was brought forward and definitely before the present credit difficulties. Finally, as the money is only accelerated and not additional, what will happen in 2010-11?

The Parliament is becoming accustomed to SNP broken promises, such as the dropping of the £2,000 grant for first-time buyers and yesterday's momentous announcement that the Scottish Government has abandoned its plans for a local income tax. I sincerely hope that the cabinet secretary will fight her corner in the Cabinet and will find new money for house building. Perhaps the new minister will help her to find that courage and to keep the promises on house building.

Question Time — Scottish Executive — General Questions

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

To ask the Scottish Executive what proposals it has to move freight on to the far north line. (S3O-5919)

Stewart Stevenson (Scottish National Party, Banff and Buchan)

The Scottish Government offers a number of freight facilities grant schemes to encourage a shift from road to rail. However, the mode of transport for freight is a commercial decision for the freight service provider and the customer.

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

As I drive home on a Thursday night, I find myself having to overtake an endless line of Tesco lorries as I travel between Edinburgh and the far north. Why cannot Tesco put those loads on to trains in the way that Safeway did in the good old days, when goods travelled by rail to Georgemas junction? What are the constraints on the minister that prevent him from making that happen?

Stewart Stevenson (Scottish National Party, Banff and Buchan)

The member will be aware of my recent visit to Inverness, during which I cracked a bottle of champagne over the front end of the new Tesco train that the company will use in that part of the Highlands. In the past, freight travelled to the far north by rail, but recent takeovers have resulted in changes to the distribution network of the supermarkets in question.

I have made it clear to the supermarkets that the Government can make money available to them to help them fund delivery by rail of containers to the far north. If any member can facilitate further discussions on the matter, I would be happy to assist them. Cognisant of my climate change responsibilities, I hope that the member will consider using the train and not the car for his journeys to Tain.

Rob Gibson (Scottish National Party, Highlands and Islands)

Can the minister be more specific about the powers that are available to him to ensure that all multiple stores along the route to which Jamie Stone referred furnish their stocks via the rail network? I am thinking of powers that the Parliament has agreed to, including planning powers, and the fact that 95 per cent of those stores are within a mile of the railway line.

Stewart Stevenson (Scottish National Party, Banff and Buchan)

I do not believe that we have such powers. That said, we have the power of persuasion and the capability to offer financial support. The powers that are available to us are applicable in certain limited circumstances and include designating parts of the road network as unavailable to lorries. However, I doubt whether those powers could be applied in this case. I am always happy to look at innovative ways of ensuring that we get freight traffic off the roads. We want fewer lorries on the roads north of Inverness than the 400 vehicles to which I have heard Mr Stone refer.

Mary Scanlon (Conservative, Highlands and Islands)

I look forward to the day when we follow Asda lorries up the A9 on our way north.

It takes three hours and 40 minutes to travel by rail from Inverness to Caithness. What plans does the Government have to reduce that journey time?

Stewart Stevenson (Scottish National Party, Banff and Buchan)

In terms of the railway network across Scotland and, in particular, rail journeys north of Inverness, the main and early intervention that can be made is to revise signalling arrangements. The signalling north of Inverness is reaching the end of its life. We may follow the example of the Cambrian line south of the border, which was an early adopter of the European signalling system. If we were to follow that route, it would help not only to refettle the infrastructure but to reduce journey times. Although we have yet to make the decision, that would be our likely approach.

Mary Mulligan (Labour, Linlithgow)

To ask the Scottish Executive what improvements have been made to transport infrastructure in the Linlithgow constituency since May 2007. (S3O-5953)

Stewart Stevenson (Scottish National Party, Banff and Buchan)

I am pleased to state that work will commence this month on the Airdrie to Bathgate line. Improvements will also be undertaken to passenger facilities along the entire length of the route. Additionally, under the access for all small schemes programme, work is taking place to install two smart help points and the react navigation system at Linlithgow station. Of course, there is the on-going maintenance of the trunk roads in the Linlithgow constituency, which is covered by Transport Scotland's maintenance contracts.

Mary Mulligan (Labour, Linlithgow)

The minister is aware of my consistent support for a station at Blackridge on the new Airdrie to Bathgate line. He is also aware that the housing company that was to contribute to the funding of the new station by way of a section 75 consent has gone into receivership. The Labour-Liberal Democrat Scottish Executive committed £300 million to the Airdrie to Bathgate line. Will the minister commit the funds that are necessary to ensure that Blackridge station is built, as a number of Scottish National Party MSPs have promised, or will this become another broken SNP promise?

Stewart Stevenson (Scottish National Party, Banff and Buchan)

Mary Mulligan has heard from this minister on many occasions his absolute commitment to the delivery of Blackridge station. We now have to deal with the administrator on the technical and legal issues that relate to the land for the station. On finance, we have identified efficiencies elsewhere in the delivery of the line. As a result, it is likely that financial inhibitions will not cause us any problems.

Mary Mulligan and all members in the chamber should be absolutely assured that I am committed to the delivery of that station. I am working very hard to ensure that, in the face of difficult circumstances, we shall deliver it.

Mike Pringle (Liberal Democrat, Edinburgh South)

To ask the Scottish Executive what support it will offer retired and senior people wishing to volunteer following its decision to withdraw funding from the retired and senior volunteer programme. (S3O-5913)

Jim Mather (Scottish National Party, Argyll and Bute)

We believe that volunteering plays an important part in creating strong communities. We support Volunteer Development Scotland in its role as the Scottish centre of excellence in volunteering and we have provided £11 million over three years to support the 32 volunteer centres across Scotland. Many retired and senior volunteers make considerable use of the services that are offered by the volunteer centres.

Mike Pringle (Liberal Democrat, Edinburgh South)

In his written response to a constituent of mine who raised concerns about the ending of the RSVP grant, the minister said that he had encouraged CSV to engage further with community planning partnerships and local authorities to find funding.

As much as the minister would like to pass the buck to local government, he knows that councils with hard-pressed local budgets and burdensome central Government targets will struggle to fund the programme. Given that the March deadline is fast approaching, will he offer some central support for retired and senior volunteers, or will he persist in making the £1 million funding cut?

Jim Mather (Scottish National Party, Argyll and Bute)

I do not agree with the member's analysis. The grant has run its natural course of three years, and CSV has known for many months that funding will come from the local level. Transitional funding could divert focus from the need to make strong connections with the CPPs and weaken the single outcome agreements. The change is on the table, and there is broad acceptance of the new reality. We have had meetings with Claire Stevens, who is CSV's director in Scotland, and Hammy Smillie, who is a member of the CSV Scotland advisory board. They accept the new reality; the member should do that, too.

Sarah Boyack (Labour, Edinburgh Central)

Is the minister aware that the RSVP supports a range of initiatives across the country, one of which is energy efficiency advice? That service is being rolled out on a peer basis: older people are giving advice to other older people. The service has had huge success in generating lower bills for older people, thereby saving them huge amounts of money. Energy costs are a major issue for older people who are strapped for cash. Is he not concerned that we could lose that service across the country if local authority funding to meet its costs is not found?

Jim Mather (Scottish National Party, Argyll and Bute)

I appreciate the point and value the work that has been done. The fact is that £21 million will be spent on volunteer centres and CSV over the next three years. We have had the conversation with Claire Stevens and Hammy Smillie on how we can help to bind CSV to the Scottish local authority economic development group, the Scottish Chambers of Commerce, the Federation of Small Businesses and the national health service in Scotland. In essence, we are trying to develop a new localism. I believe that that will be forthcoming. I look to the members who have put these questions to help us in that process.

Frank McAveety (Labour, Glasgow Shettleston)

To ask the Scottish Executive what steps it will take to strengthen enforcement of the legal age limit for the purchase of alcohol. (S3O-5945)

Kenny MacAskill (Scottish National Party, Edinburgh East and Musselburgh)

We are implementing the Licensing (Scotland) Act 2005 in line with the previous Government's timetable. The act allows licensing boards to take tough action and crack down on rogue retailers. We have rolled out test purchasing, thereby providing the police with an additional tool—one that is based on intelligence—to tackle underage sales. The police have carried out more than 1,200 test purchases and there is already evidence that that work is proving successful.

However, we need to get out of the mindset that this issue is only about enforcement and only about young people. We know that many young people get alcohol from their home, not from shops. We also know that alcohol misuse affects all age groups, not just young people. That is why we need to kick-start a culture change and to try some new approaches, and that is what we will do.

Frank McAveety (Labour, Glasgow Shettleston)

My local Co-operative store in Shettlestone Road has developed policies that are aimed at enforcement and at educating younger citizens about access to alcohol. Will the cabinet secretary support Labour's call to make challenge 21 mandatory? Is that a real possibility—yes or no?

Kenny MacAskill (Scottish National Party, Edinburgh East and Musselburgh)

That is the law that was brought in by the previous Administration in the Licensing (Scotland) Act 2005, which will kick in in September. Retailers should not sell alcohol to under-21s unless they are absolutely certain that they are over 18, and should require proof of their age where there is any doubt. Any retailer who breaches that instruction is in breach of licensing law. Mr McAveety is behind the times. That is the law. We accept that it should be enforced, and we commit fully to ensuring that it is.

Having been out in Mr McAveety's city with members of the licensing board on Saturday night, I can assure him that I know that his colleagues on the licensing board also view the matter as vital.

Alasdair Morgan (Scottish National Party, South of Scotland)

Does the cabinet secretary agree that the control of underage and irresponsible drinking is far better done via the public house than via the off-licence, where it cannot really be done at all? What measures can he take to switch the balance of advantage from the off-licence to the public house, which is often priced out of the market by supermarkets?

Kenny MacAskill (Scottish National Party, Edinburgh East and Musselburgh)

The Government has been discussing and consulting on that matter. A variety of interested groups and parties are taking positions on the issue of minimum pricing.

I agree with the member that there has been a continuing professionalisation of the on-sale trade and that there is a benefit from the supervision of alcohol consumption by a professional body that should seek to ensure that that consumption is regulated. Last Saturday in Glasgow, I saw that the situation is, in the main, well policed and that matters are well dealt with, and I am aware that the situation is the same in other jurisdictions.

As the Deputy First Minister has said, the sale of alcohol at pocket-money prices is unacceptable, and there is, frankly, something wrong in our society when someone can buy cheap, high-strength alcohol for far less than a bottle of water.

Christine Grahame (Scottish National Party, South of Scotland)

Will the cabinet secretary give thought to the idea of transferring the responsibility for policing underage sales of alcohol from the police to trading standards officers, who currently have responsibility for detecting underage tobacco sales? I submit that that would be a more efficient arrangement and would release police for other duties.

Kenny MacAskill (Scottish National Party, Edinburgh East and Musselburgh)

There is some merit in that suggestion. These matters are under constant discussion. In my experience, the arrangement between the police and the licensing standards officers works well.

If I may hark back once more to my visit to Glasgow on Saturday night, I can tell the member that I met two sets of two licensing standards officers who were out and about. In rural areas, the situation might be different, because the size of the area that is involved often means that the role of licensing standards officers is conjoined with the role of trading standards officers.

We must ensure that the law is enforced. Who should do that is a matter that is, perhaps, best dealt with in partnership, bearing in mind the fact that different arrangements will apply in different localities.

The issue depends fundamentally on the vigorous enforcement of the law to ensure that our youngsters are not sold alcohol when they should not be. Frankly, that is not just a matter for enforcers. As Alasdair Morgan implied, each and every person in the community has a responsibility in that regard. Far too many adults purchase alcohol for youngsters. The real problem is not so much rogue retailers but agency purchase, whether deliberate or misguided, and that has to stop.

Jamie Hepburn (Scottish National Party, Central Scotland)

To ask the Scottish Executive what discussions it has had with Her Majesty's Government regarding its recapitalisation of the banking sector and any impact that this might have on Scottish Government spending. (S3O-5891)

John Swinney (Scottish National Party, North Tayside)

I have been in correspondence with the Chancellor of the Exchequer regarding the recapitalisation of the banking sector and the work of UK Financial Investments Ltd. Any direct impact on Scottish Government spending is likely to arise through the reductions in public spending that are expected to be made by the United Kingdom Government in 2010-11 and 2011-12.

Jamie Hepburn (Scottish National Party, Central Scotland)

Although I agree that we should all be concerned about those impending cuts, I would like to explore another issue relating to the recapitalisation of the banks.

The cabinet secretary will be aware that private finance initiative payments between now and the end of 2033-34 across the UK come to £216 billion. Does he agree that, in the interests of securing better value for the public purse, the recapitalisation of banks that are involved in public-private partnerships or PFI consortia could be renegotiated? Is he as concerned as I am that, in a letter to me, the Treasury ruled that out on the basis that it would undermine the share price of those banks?

John Swinney (Scottish National Party, North Tayside)

Clearly, there is a possibility that those PFI and PPP contracts could be renegotiated. Where doing so would be in the public interest, I would like that to happen, so that we can try to deliver greater value for the public purse and more effective use of those funds as a consequence of the climate in which we now operate.

Malcolm Chisholm (Labour, Edinburgh North and Leith)

Does the cabinet secretary accept that increased levels of borrowing by the UK Government have had a positive effect on Scottish banks, consumers and public services? If so, does he also accept that those increased levels of borrowing will have an effect in due course on levels of public expenditure?

John Swinney (Scottish National Party, North Tayside)

Mr Chisholm takes us on to ground that is certainly causing me a great deal of concern, because the prognosis for public expenditure in the period from 2010-11 onwards is extremely serious. I am aware that the Parliament, which operates within a fixed financial envelope, will be directly challenged by the impact of those UK public expenditure cuts. That is what lies at the heart of the Government's unease at the situation that we face. Quite clearly, Parliament will have to wrestle with the issue in the course of considering the preparations for the 2010-11 budget. That is why I welcomed the initiative from the Liberal Democrats to encourage greater dialogue within the political parties in Parliament on how we can address that situation. I will be taking forward action on that as a matter of priority.

Ian McKee (Scottish National Party, Lothians)

To ask the Scottish Executive what measures it is taking to introduce the benefits of modern business management techniques to public services. (S3O-5895)

John Swinney (Scottish National Party, North Tayside)

We are committed to ensuring that an appropriate range of modern techniques is used across the public sector in Scotland. We particularly welcome examples of best practice.

Ian McKee (Scottish National Party, Lothians)

Will the cabinet secretary join me in acknowledging the success of NHS Lothian's modernisation team, lean in Lothian, in reducing waiting times for computed tomography scans, improving the efficiency of sterilisation of surgical instruments and effecting improvements in many other fields? Does he share my belief that a crucial factor in the team's success is the fact that it involves staff at all levels in effecting change? Does he recommend the adoption of lean techniques, including kaizen blitzes, in other areas of the public sector?

John Swinney (Scottish National Party, North Tayside)

Dr McKee quite rightly applauds the work of the lean in Lothian team, which is particularly commendable. The reduction in waiting times for CT scans from 21 weeks to four weeks is a great tribute to the improvements in methodology that have been deployed.

The Deputy First Minister and I are anxious to ensure that examples of best practice are taken from one aspect of the public services and applied to others. I know that, within the health service, there is a great appetite to ensure that, in many of the areas of activity that Dr McKee mentioned and across the national health service in Scotland, the lessons of the lean in Lothian team are learned.

John Wilson (Scottish National Party, Central Scotland)

To ask the Scottish Executive whether it has proposals with regard to updating and increasing flexibility of the traditional one-week work experience for secondary school pupils. (S3O-5864)

Fiona Hyslop (Scottish National Party, Lothians)

The Scottish Government recognises that work placements for secondary school pupils are an important part of the senior phase of learning in the curriculum for excellence. We will consider fully the findings of our recent research on work experience, and we will work with local authorities and other stakeholders to maximise flexibility and choice and to ensure that placements are relevant and meaningful for all young people.

John Wilson (Scottish National Party, Central Scotland)

The cabinet secretary mentioned the "Work Experience in Scotland" report that was commissioned by the Scottish Government. It indicated that work experience has not been updated since the 1980s. Will it be updated to take account of the number of students who remain in school in secondary 5 and secondary 6, in order to ensure that they receive more targeted and relevant work placements?

Fiona Hyslop (Scottish National Party, Lothians)

It is appropriate that we update work placements. Vocational learning has to be improved. Traditionally, there is one block of vocational training in S4, but I think that flexibility to depart from the traditional one-week block would be in order. Suggestions on that will be welcome as we move towards rolling out improvements to work placements for senior pupils in secondary schools.

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

The cabinet secretary will be aware that, until last year, work experience for pupils at Borders schools was co-ordinated within the Borders with Careers Scotland staff. As a result of the creation of the centralised quango, Skills Development Scotland, that co-ordination is now done from Paisley. How on earth can the Government expand work placements when the necessary organisational work is not being carried out at a local level?

Fiona Hyslop (Scottish National Party, Lothians)

Scottish Borders Council is more than capable of ensuring that pupils from its secondary schools have relevant placements with employers. The curriculum for excellence provides us with great opportunities for innovative and more flexible delivery. Scottish Borders Council is fully capable of rising to the challenge.

Alex Fergusson (None, Galloway and Upper Nithsdale)

Before we move to questions to the First Minister, I invite members to join me in welcoming to the gallery His Excellency Jan Winkler, the Czech Republic's ambassador to the United Kingdom. [ Applause. ]

First Minister's Question Time

Iain Gray (Labour, East Lothian)

To ask the First Minister what engagements he has planned for the rest of the day. (S3F-1446)

Alex Salmond (Scottish National Party, Gordon)

I have a variety of engagements to take forward the Government's programme for Scotland, including an arranged call with Rhodri Morgan, the Welsh First Minister.

Iain Gray (Labour, East Lothian)

That will be a change from yesterday, when the First Minister threw the Government's programme for Scotland into reverse. Yesterday, when he dumped his flagship local income tax, he was caught redhanded selling short Scottish voters—his own definition of a spiv and speculator. This week, even the bankers had to say sorry. Will he say sorry to the Scottish voters for the way that he conned them?

Alex Salmond (Scottish National Party, Gordon)

Apologies are required from the council tax cabal of Labour and the Tories, who have voted to uphold the council tax in Scotland—it is a Valentine's day love-in between the Labour and Conservative parties. There should also be apologies from those at Westminster who are planning £500 million of cuts in Scottish public services.

As I said, I am calling Rhodri Morgan this afternoon. In preparation for that call, I looked through what Rhodri Morgan has had to say about proposed public spending cuts from Westminster. In December, he said:

"now is the wrong time to be cutting public spending".

If Rhodri Morgan can speak for Wales, why is Iain Gray not allowed to speak for Scotland?

Iain Gray (Labour, East Lothian)

Sorry truly is the hardest word. As usual, the First Minister, in a crisis, blames everyone, blames early and blames often. As the First Minister retreats in the snow from his local income tax, like Napoleon from Moscow, he is still shaking his fist and declaring that local income tax will be back. However, we all know that LIT is just a bad policy. It would damage the Scottish economy and destroy local services. Even the Tories have told the Scottish National Party that, and they know all about bad taxes and destroying services. The First Minister conned the voters once with LIT; it would be shameless to try to con them again. Will he dump this unwanted and unworkable tax for good?

Alex Salmond (Scottish National Party, Gordon)

There is no point in Iain Gray attacking the Conservatives—he and the Conservatives have been combining to vote down local income tax in the Parliament.

The SNP manifesto had 94 headline manifesto commitments. I am delighted to tell Parliament that we have already achieved 46 of them—almost half—and, as Labour members know, we are not yet halfway through the parliamentary session.

I remember a revealing interview given by Iain Gray, when he became the Opposition leader, in which he explained why Labour had not implemented its promises to reform council tax. He said that the previous proposals were drawn up

"on the back of a fag packet",

so I do not think that Iain Gray is in a position to lecture any party about proposals for local government finance.

Iain Gray (Labour, East Lothian)

Let us see what position the First Minister is in to lecture us about competence. Two weeks ago, the Parliament threw out the First Minister's budget, because it was not up to the job. This week, the First Minister threw out three of his ministers, because they were not up to the job. Yesterday, he threw out his flagship policy, because it is not up to the job. The First Minister's credibility is shot to pieces. Is it not Alex Salmond who is not up to the job?

Alex Salmond (Scottish National Party, Gordon)

Last week, the budget was passed by a resounding majority, with the support of the Labour Party. As for ministerial changes, I have been glancing back at the previous two sessions. If we exclude changes that were made for tragic reasons, there were 21 changes to the Labour-Liberal Democrat Administration in two sessions. The figure includes Frank McAveety, who managed to resign twice—once in each session. This Administration is a sea of calm compared with the chaos that reigned during the Labour-Liberal Administrations. Perhaps that is why we are leading in the opinion polls and support for Scottish independence is strengthening, as people recognise the implications of a £500 million cut in Scottish public expenditure, planned by Westminster and accepted by Iain Gray.

Alex Fergusson (None, Galloway and Upper Nithsdale)

This is Iain Gray's final question.

Iain Gray (Labour, East Lothian)

Here is the manifesto that Mr Salmond was talking about. Paying off student debts—that is gone. A replacement for public-private partnership—that is gone. Replacing the council tax—that, too, is now gone. The only flagship policy in the SNP manifesto that is left is independence—tearing Scotland out of the UK. Business does not want that. Trade unions do not want that. It would ruin Scotland's economy. Not a single opinion poll has shown that the Scottish public want independence—not one, not ever.

There is no majority in the Parliament for independence. If that is good enough for LIT, it is good enough for independence. Let us finish the job of tearing up the SNP manifesto. Will the First Minister dump independence, as well, right now?

Alex Salmond (Scottish National Party, Gordon)

If Iain Gray wanted the fair system of local tax that we have proposed, why on earth did he not vote for it in the Parliament?

I notice that Iain Gray is trying to avoid the subject of the £500 million of Labour cuts. Is he doing so because of Andy Kerr's remarkable interview on "Good Morning Scotland", which should be put on the record so that everyone can be treated to the full extent of its absurdity? The highlight was Andy Kerr's response when he was asked what he thought the level of cuts would be. He answered that well, funnily,

"no one knows the exact figure, because it has not been worked through the system."

However, the analysis that is before the Parliament's Finance Committee points to £500 million of Labour cuts.

As for the referendum on independence, is that really Iain Gray's strongest suit? Let us say that SNP members are still with the Duncan declaration—the commitment from Duncan McNeil on 6 May last year. He said that all Labour MSPs

"agreed with the new policy, some were relieved and that they would support a referendum whenever it was called."

We are confident that, having made the blunder of stopping a fair system of local taxation in Scotland, even the Labour Party would not try to deny the people of Scotland the right to vote on their future.

Alex Fergusson (None, Galloway and Upper Nithsdale)

We will have one final brief question from Iain Gray.

Iain Gray (Labour, East Lothian)

Here is what David Bell, the adviser to the Parliament's Finance Committee, said:

"The effect of the changes announced in the 2008 PBR on Scotland's DEL resource allocation coming through Barnett consequentials will not be significant."

This is a fig-leaf to cover up a U-turn on a policy that would not work.

Alex Salmond (Scottish National Party, Gordon)

Funnily enough, I have David Bell's paper in front of me here. On the 2010-11 resources, David Bell said:

"If these savings are shared equally across DEL budgets, then the Scottish Government's budget would fall by £380m".

He went on to analyse the health budget:

"This is not a reprofiling and will mean a recurring reduction of around £125m in the Scottish Government capital budget."

I point out to Iain Gray that £380 million plus £125 million comes to £505 million. That is a figure that Iain Gray and Andy Kerr had better get used to, because it will haunt them every day from now until the Scottish general election.

Annabel Goldie (Conservative, West of Scotland)

To ask the First Minister when he will next meet the Secretary of State for Scotland. (S3F-1447)

Alex Salmond (Scottish National Party, Gordon)

I have a couple of meetings with the secretary of state coming up over the next few weeks.

Annabel Goldie (Conservative, West of Scotland)

The exchange between the First Minister and Mr Gray highlights two things: that the Scottish Government has indeed scrapped another flagship policy; and that the Labour Party has nothing to offer apart from volumes of verbosity. One thing is clear, however: the council tax remains with us, and only the Scottish Conservatives have a viable plan to reform it, to cut it for every household in Scotland and to go further for our pensioners.

In Labour's recession, a council tax freeze is a welcome first step. Just a few weeks ago, the First Minister agreed with the Scottish Conservatives that a council tax freeze is not enough. Given that we are now keeping the council tax, just what does the Scottish Government propose to do?

Alex Salmond (Scottish National Party, Gordon)

I would be the first to acknowledge the Conservative party's enthusiasm for having policies on the matter. Indeed, it has had five policies in the past five years. There was the real-terms freeze—real-terms, note—in 2003. There was a discount of £500 million in the 2005 manifesto. There was cutting half of council tax for pensioners under the manifesto of 2007. Then there was Derek Brownlee's declaration last year that council tax would be cut by about 25 per cent. It culminated in David Cameron's agreement, towards the end of last year, that a council tax freeze was an excellent thing to propose.

I accept that there are elements of sense in those five policies, particularly in the argument for a council tax freeze. When any party in the Parliament puts forward elements of sense, the Government is of course willing to listen. However, I cannot help feeling that what people in Scotland want is a new system of taxation that is fair and based on the ability to pay, rather than attempts to mitigate the impact of the unfair council tax.

Annabel Goldie (Conservative, West of Scotland)

The First Minister has just stated the absurd. If the local income tax policy were such a sound, solid, workable and fair one, as he claimed at the time of the election, when he was so intent on wooing voters, why is he not prepared to go to the ramparts to fight and argue for it, and to get it delivered?

The First Minister knows that his policy has been discredited, that it is unmanageable, that it is incapable of being delivered and that it has been meeting with increasing criticism and condemnation from just about every quarter of opinion in Scottish society. I thank him for giving credit to the Conservatives for at least having a policy on council tax, but he has failed to tell me what the Scottish Government proposes to do, now that it has ditched its discredited local income tax and is leaving us with the council tax. What exactly has he got that he can tell council tax payers about?

We now know—

Alex Fergusson (None, Galloway and Upper Nithsdale)

A question, please.

Annabel Goldie (Conservative, West of Scotland)

The jobless total in Scotland has risen by nearly 50 per cent in the past 12 months and all predictions for the economy are chilling. Repeatedly, the Cabinet Secretary for Finance—

Alex Fergusson (None, Galloway and Upper Nithsdale)

No—a question, please, Miss Goldie. I must press you.

Annabel Goldie (Conservative, West of Scotland)

Mr Fergusson, given that Mr Gray was allowed five questions, I think that I might be allowed an expanded second one.

Alex Fergusson (None, Galloway and Upper Nithsdale)

Come to a question, please, Miss Goldie.

Annabel Goldie (Conservative, West of Scotland)

The Cabinet Secretary for Finance and Sustainable Growth explained that he had the £281 million that would have been necessary to subsidise his now defunct local income tax. Will the First Minister, as the Scottish Conservatives have repeatedly demanded, cut council tax bills for every household in Scotland using that money? That is the only proposal in town at the moment.

Alex Salmond (Scottish National Party, Gordon)

Annabel Goldie should come to terms with the £500 million cut in public spending that is proposed by the Westminster Government. We and all sensible parties in the chamber will fight against that, but we cannot ignore that it—or something like it—is being proposed in the pre-budget report. That is something that is coming at the Scottish people, the Scottish Government and the Scottish Parliament.

Annabel Goldie asks what we are going to do. We have every confidence that councils around Scotland will today follow the lead of the four that have already voted for a council tax freeze. We hope and believe that another 18 councils will vote for a council tax freeze in council chambers this afternoon. Why is that significant? It is because the Conservative party, which introduced the council tax, put it up by 40 per cent and, in the 10 years from 1997, under Labour, it went up another 60 per cent. The reason why the council tax freeze in Scotland is so widely welcomed is that those parties—the council tax parties—between them managed to double the council tax. That is why people in Scotland will think that effective action by the Scottish National Party Government is providing relief for household bills. That is why they continue to support the SNP Government.

Tavish Scott (Liberal Democrat, Shetland Islands)

To ask the First Minister what issues will be discussed at the next meeting of the Cabinet. (S3F-1448)

Alex Salmond (Scottish National Party, Gordon)

The next meeting of Cabinet will discuss issues of importance to the Scottish people.

Tavish Scott (Liberal Democrat, Shetland Islands)

The First Minister's election address for Gordon features smiling people, who said that they were voting for Alex Salmond because he would abolish the unfair council tax. Are they still smiling, or will he simply use the same photo for the next election address?

Alex Salmond (Scottish National Party, Gordon)

Tavish Scott and the Liberal Democrats should accept—the votes in the Parliament certainly indicated as much—that it was not going to be possible for us to find an agreement on a proposal for a local income tax to replace the council tax. They should accept that the vote on 4 December indicated that our support for the local income tax was not going to produce enough votes to carry the chamber. It is only a week or so since Tavish Scott accepted that his proposal for a 2p cut in income tax did not carry the support of the chamber. Where am I wrong in saying that, despite our support for a fair system of local taxation, we did not have the votes in the chamber to carry it?

Tavish Scott (Liberal Democrat, Shetland Islands)

I am grateful to the First Minister for mentioning votes in Parliament. This week, the First Minister has got his priorities wrong. He did not appoint a new minister for economic recovery; he appointed a new superminister for independence, grandstanding in Parliament, holding roadshows in every town, wasting taxpayers' money and soaking up time—time that should be used to strengthen small business in the face of recession, to help the eight unemployed people chasing every vacancy, and to turn round stalled economic growth.

We need action on recession, not rhetoric on secession. Why does the First Minister not follow his new Salmond rule of government, which says, "You can abandon any promise, however solemn, as long as you've got a long enough list of people to blame." He can drop the independence bill and put my name on the list of people to blame. Will he focus the Government on finding the way out of recession and abandon the independence bill here and now?

Alex Salmond (Scottish National Party, Gordon)

It is only a week since Tavish Scott and the Liberal Democrats supported the Government's budget. They were able to do so precisely because we accepted and have as policies a range of measures that are helping Scotland to combat recession. As far as small business is concerned, one of the key measures is the small business bonus, which is helping tens of thousands of businesses across the country.

As I interpreted Tavish Scott's first supplementary question, he was attacking the Scottish National Party for being unable to secure a parliamentary majority to implement a manifesto commitment on local income tax. In the second question, he was asking us to abandon a manifesto commitment for an independence referendum. On the day he was elected as leader of the Liberal Democrats, he said that he was "not intuitively against" giving the people of Scotland a choice in their own future. He should go back to what he said on the day of his election, accept the democratic will of the people and support a referendum bill when it is introduced.

Peter Peacock (Labour, Highlands and Islands)

The First Minister will be aware of the shocking report on child protection services in the Moray Council area that was published by inspectors today. The report shows major failings in very basic and necessary child protection procedures. Will he, along with the Minister for Children and Early Years, ensure that the agencies in Moray are left in no doubt about the need for radical improvement in their services? Further, will the First Minister ensure that, within the next six months, inspectors return to Moray to give assurance to the population there and to the Parliament that progress is being made on the change agenda that is required?

Alex Salmond (Scottish National Party, Gordon)

The straight answer to the question is yes, I will. The Parliament should recognise the seriousness of the report on Moray Council. We should also recognise that the system of inspection that has been established in Scotland is proving to be extremely effective. Of the reports that we have had so far, 11 have shown no weaknesses in council provision, 12 have shown some areas for concern, which are being addressed, and three, including that on Moray, have shown serious deficiencies or an unacceptable level of performance. Now that an action plan is in place, it is imperative that we have strong and committed leadership from Moray Council and its partners to ensure that the plan is delivered fully. As Peter Peacock suggested, there must be no excuses or buck passing by those who are responsible. We are monitoring Moray Council's performance closely. Any failure to act will be met by action from the Scottish Government.

One issue that should give us optimism on such a serious matter is that, in the other two councils in which reports have identified serious deficiencies in the vital area of children's services—Midlothian Council and Aberdeen City Council—substantial progress has been made. I hope that I can reassure the member that the Scottish Government will ensure that the same pattern of substantial progress is repeated in Moray Council.

Kenneth Gibson (Scottish National Party, Cunninghame North)

To ask the First Minister what impact new United Kingdom visa rules for international students will have on Scotland's universities. (S3F-1449)

Alex Salmond (Scottish National Party, Gordon)

International students make an important contribution to Scotland and they help to sustain and drive forward our economy, even in these difficult times. They also enhance the cultural diversity of our country. We are concerned about the possibility of fewer international students from outside the European Union coming to Scotland. The new system limits them to a four-year visa in the first instance and will introduce additional costs. We are also concerned about the additional administrative burden and expense for our universities and colleges in implementing the system. The Cabinet Secretary for Education and Lifelong Learning has on several occasions written and spoken to UK ministers about our concerns. We will continue to press UK ministers on the issues. Specifically, we urge that dialogue between Home Office officials and stakeholders should continue through the joint education task force.

Kenneth Gibson (Scottish National Party, Cunninghame North)

As the First Minister is aware, more than 58,000 overseas students study in Scotland. Based on the experience in the United States post-9/11, the Labour Government's plan to introduce new and incredibly complex visa rules could cost Scotland's universities up to £50 million a year, which is why Universities Scotland has expressed serious concerns. Does he agree with Universities Scotland that scaring away overseas students

"with complex regulations would be madness for our economy and madness for our society",

and that

"With America opening its doors to students again, and many other countries stepping up recruitment strategies, this is the worst possible time to tie the hands of Scottish universities recruiting overseas"?

Alex Salmond (Scottish National Party, Gordon)

Yes, I agree. I saw a story on that in the Sunday Herald at the weekend, which I think contained that quotation from Universities Scotland. Some progress has been made in the past year, although not enough. The new system originally would have required students to have substantial funds—£800 a month—but, following representations, that was cut. We have lost the Scottish advantage through the fresh talent initiative's two years' leave to remain, as that now applies throughout the UK, but we successfully retained the higher national diploma qualification as a criterion for the scheme. As that pertains only in Scotland, that is therefore still an advantage. We successfully opposed the proposal in a consultation document to cut the leave to remain for academic visitors from 12 months to three months. After representations, that proposal was reversed.

However, those concessions are not enough. The attitude that seems to be displayed through the new system is fundamentally wrong-headed. We should encourage more overseas students into our universities because they strengthen our academic system, universities' finances and cultural diversity. I hope and believe that the entire chamber can unite on that point in getting the argument across to the UK Government.

Claire Baker (Labour, Mid Scotland and Fife)

Does the First Minister recognise that the four-year visa covers the vast majority of Scottish degrees, that renewing the visa should be straightforward for genuine students and that the visa charges are not significant compared with international students' fees? Scottish colleges strongly welcomed the visa moves, believing that they will weed out bogus institutions and students. As he recognises, the previous Scottish Government showed, through the fresh talent initiative, that negotiation can secure more suitable terms for Scotland in relation to immigration and border control. Will he work with the whole Parliament on a cross-party basis so that we can all focus on delivering the improvements that Scottish universities want to see?

Alex Salmond (Scottish National Party, Gordon)

Yes, we will work with the whole Parliament, which is what I said in my first answer. However, Claire Baker should recognise that the universities and colleges have very serious concerns about the proposed system. I outlined some of the concessions that we have been able to win from, or agree with, the UK Government over the past year, which will mitigate some of the effects that people are concerned about. However, make no mistake—the colleges and universities are seriously concerned about the nature of the proposals. Although I welcome the opportunity to work with the whole Parliament, and Fiona Hyslop and others will of course make representations to UK ministers to try to persuade them to change their mind on these issues, I merely ask Labour and other members whether it would not be better if we could take decisions on these issues for ourselves as opposed to having to depend on lobbying people from elsewhere.

Richard Baker (Labour, North East Scotland)

To ask the First Minister, in light of reports that around 700 victims of human trafficking for sexual exploitation are living in Scotland, whether the Scottish Government will ask the Scottish Crime and Drug Enforcement Agency to set up an internal specialist unit to tackle this problem. (S3F-1464)

Alex Salmond (Scottish National Party, Gordon)

Human trafficking is a high priority for the Scottish Government and, indeed, for the Scottish police service. In Scotland, the pentameter 2 operation to target human trafficking in 2007-08 resulted in 56 premises being visited, 35 arrests, 59 potential adult victims being recovered and cash seizures of £17,500.

The Scottish Government has provided funding of £70,950 to the trafficking awareness-raising alliance, which provides support to women who have been trafficked for commercial sexual exploitation and aims to raise awareness among front-line staff in agencies that are likely to come into contact with victims of trafficking.

The SCDEA will continue to work with the eight Scottish forces and with United Kingdom law enforcement agencies to identify and address those responsible for human trafficking.

Richard Baker (Labour, North East Scotland)

Given those disturbing reports and Amnesty International UK's research showing that, within the UK, Scotland has a disproportionate number of victims of such offences, is it not time to establish a unit in the SCDEA to tackle trafficking? Will the First Minister not only continue constructive engagement with UK counterparts on trafficking but consider reform of the law, because the successful police operations in Scotland against these appalling crimes of exploitation, to which he referred, have not been followed by prosecutions?

Alex Salmond (Scottish National Party, Gordon)

We will listen to any constructive proposals to address what is a serious problem. The estimate that we provided was based on research that focused on data from the police, the statutory agencies, victims services and non-governmental organisations. It was a substantial piece of data. Richard Baker should acknowledge that Amnesty International UK said that it

"welcomes the funding made available by the Scottish Government for local authorities to support victims of other forms of trafficking. Scotland is the only part of the UK with this provision."

Jackson Carlaw (Conservative, West of Scotland)

To ask the First Minister, in light of the decision to prevent local authorities from charging pensioners for assistance with food preparation, what guarantees the Scottish Government will offer that charges hitherto levied will be refunded. (S3F-1455)

Alex Salmond (Scottish National Party, Gordon)

In her statement to Parliament on 7 May 2008, the Cabinet Secretary for Health and Wellbeing accepted Lord Sutherland's finding that the current legislation on charging for food preparation was not clear. She committed to working with the Convention of Scottish Local Authorities to prepare clarifying legislation.

We have prepared the revised legislation with the support and assistance of COSLA and the Association of Directors of Social Work, and we laid it before Parliament on Monday. That will ensure that there is clarity on those food preparation services for which vulnerable older people who need help with food preparation in their own homes cannot be charged.

The issue of possible refunds of previous charges is a matter for each council. It depends on the specific circumstances and assessed needs of each individual client, in the light of legislation as it applied at that time.

Jackson Carlaw (Conservative, West of Scotland)

I thank the First Minister for the first part of his reply, but he must accept that, after two years in government, the new regulations, however welcome, have been a long time coming. Given that his Government supported the resolution of the Parliament last May, what action will he personally take to instruct councils—including Argyll and Bute Council and Renfrewshire Council in the west of Scotland—to reimburse all pensioners who have been illegally charged?

Alex Salmond (Scottish National Party, Gordon)

Action has been taken. For the first time, the Parliament's aspiration for free personal care as it was originally envisaged is being backed by the legislative process and by the Government's implementation of the policy. Jackson Carlaw should welcome that, as pensioners and their families around the country most certainly do.

I do not need to tell Jackson Carlaw about the difficulties with retrospective legislation. He knows as well as I do that retrospective legislation is extremely difficult. Obviously, before introducing legislation, we have been encouraging councils to do the right thing by their pensioners. Only a very few councils in Scotland are still charging. For example, Argyll and Bute Council stopped charging from September 2008. I note that one of the few remaining councils that is still charging—Scottish Borders Council—is one of the few that have a Conservative administration. In terms of exhorting councils, we should be exhorting all the parties involved. Jackson Carlaw should face his responsibilities in that, as we in the Scottish Government are facing ours.

Question Time — Scottish Executive — Health and Wellbeing

Nicola Sturgeon (Scottish National Party, Glasgow Govan)

We issued a consultation paper on 22 October last year on our proposals to amend the eligibility criteria for providers of primary medical services. The responses to the consultation supported the Government's key proposal, and we will shortly introduce legislation that will preclude the commercialisation of GP practices.

Shirley-Anne Somerville (Scottish National Party, Lothians)

The Government's swift action on the matter has been welcomed by both health professionals and members of the public, as the threat of the commercialisation of health services has been a great concern to many. Will the cabinet secretary give further details of the changes that will happen following the recent consultation to ensure that there will be no privatisation of GP services in Scotland?

Nicola Sturgeon (Scottish National Party, Glasgow Govan)

I thank Shirley-Anne Somerville for raising the matter. As she and other members will be aware, vacant GP practices in Scotland are rare, but when a vacancy arose in Harthill a couple of years ago a bid was received from the commercial sector. That brought to everybody's attention the loophole that exists in the legislation.

The new eligibility criteria for which we intend to legislate will require all parties to the contract—all the partners in the case of a partnership and all the shareholders in the case of a company—to be individuals who are engaged in the provision of primary medical services to patients. That will support the principle of a mutual national health service. If a company has shareholders who have only a financial interest in the company and are not actively involved in providing primary medical services, it will not be eligible to hold a contract. That is an important step forward. The approach was warmly supported in the consultation, and members will be aware that the British Medical Association strongly supports it as well.

Jamie McGrigor (Conservative, Highlands and Islands)

To ask the Scottish Executive what support it is giving to housing associations in the west Highlands. (S3O-5863)

Nicola Sturgeon (Scottish National Party, Glasgow Govan)

In the current financial year, the Scottish Government has allocated a total of £20.69 million from the affordable housing investment programme to the six housing associations that operate primarily in the west Highlands. This year's AHIP across the wider Highlands and Islands and Argyll and Bute has increased by 12.3 per cent from £54.45 million to £61.17 million.

Taking into account the accelerated spend and pre-budget report consequentials, we are making £531 million available across Scotland in 2008-09. In the next financial year, that will rise to £644 million, which represents a 21 per cent increase.

Jamie McGrigor (Conservative, Highlands and Islands)

Can the cabinet secretary confirm that Argyll Community Housing Association is measured against a housing association grant benchmark of £73,000 but that the corresponding figure for Lochaber Housing Association is £108,000 per unit? If that is correct, does she agree that the matter needs to be revisited? Surely two neighbouring housing associations that operate in similar geography and housing markets should not have such different benchmarks.

Nicola Sturgeon (Scottish National Party, Glasgow Govan)

The member will be aware that there is flexibility in the HAG system. He is right to say—if this is what he was saying—that there is a national subsidy target of £73,000 per unit. However, the Scottish Government has approved and will continue to approve higher costs under certain circumstances—for example, in rural or island areas—when they can be objectively justified. We will offer higher allowances for smaller associations because we recognise that their costs can be higher. There is scope for local variation when projects are approved if there are additional costs that can be objectively justified.

If different HAG subsidy rates are applied to the two housing associations that the member mentioned, that is presumably because one has been able to demonstrate objectively that it has higher costs and the other has not. If the member wishes to discuss the matter in more detail, I will be more than happy to do so in person or in writing.

Bill Wilson (Scottish National Party, West of Scotland)

To ask the Scottish Government, in light of a study by Scottish researchers published in The Lancet on 8 November 2008 showing that populations exposed to the greenest environments have the lowest levels of health inequality related to income deprivation, what it is doing to ensure equitable access to quality green space for the most deprived communities. (S3O-5905)

Shona Robison (Scottish National Party, Dundee East)

The Scottish Government supports the delivery of well-designed, sustainable places where everyone can access the amenities and services that they need. We provide direct support for the promotion of green space through the funding of organisations such as Greenspace Scotland and initiatives such as paths to health and green gyms. We also fund research into the links between green space and health. "Equally Well", the report of the Scottish Government's task force on health inequalities, recognises the importance of healthy physical environments in tackling health inequalities and outlines the actions that are taken as a result of that link.

Bill Wilson (Scottish National Party, West of Scotland)

According to Greenspace Scotland and Dr Richard Mitchell, accurate data on green space are essential for research into health benefits. Green space has been mapped in 25 local authority areas using geographic information system maps and aerial photography. Renfrewshire Council is one of the first to complete that and to put in place systems to update its data. Does the Scottish Government have any plans to support the mapping of the remaining seven local authority areas?

Shona Robison (Scottish National Party, Dundee East)

I will certainly look at that, because it is important that we identify which areas to focus our attention on. It is obviously important for our partnership working with local authorities that we are able to do that.

As part of improving our understanding, we are funding research into the links between green space and health, which will input into policy development across a range of areas. I am sure that we will take that forward with our local authority partners to improve their understanding, too.

Jackson Carlaw (Conservative, West of Scotland)

To ask the Scottish Executive what steps it has taken to secure an agreement over funding between St Margaret of Scotland Hospice and NHS Greater Glasgow and Clyde. (S3O-5870)

Nicola Sturgeon (Scottish National Party, Glasgow Govan)

I understand that NHS Greater Glasgow and Clyde will discuss that matter at its next board meeting which will be held on 24 February. I have said before, and I will say again, that it is essential that an appropriate and sustainable solution that reflects national and local priorities is achieved without undue delay.

Jackson Carlaw (Conservative, West of Scotland)

I recently wrote to the cabinet secretary regarding the progress, or lack of it, in the on-going discussions about the future of the hospice. It appears that those charged with reaching an agreement have lost all confidence in one another, which has led to a complete breakdown in discussions. That Scotland's oldest and largest hospice could be lost on that basis is ludicrous.

I appreciate that the cabinet secretary cannot force a deal, but will she appoint a special representative who enjoys the confidence of both parties and who can realistically be charged with brokering an urgent agreement before the sand runs out on the midnight hour glass for vital continuing and end-of-life care at St Margaret of Scotland Hospice?

Nicola Sturgeon (Scottish National Party, Glasgow Govan)

I thank Jackson Carlaw for the interest that he has shown in this issue and for the constructive way in which he has pursued it. I recognise that members throughout the chamber have a genuine interest in the hospice.

I have said before that I value the services that St Margaret of Scotland Hospice provides, and I believe that NHS Greater Glasgow and Clyde does, too. It is clear that NHS Greater Glasgow and Clyde needs to commission services that it considers are required for the population that it serves and, of course, the hospice has a right to consider what services it feels able to provide.

I note the suggestion that Jackson Carlaw has made—indeed, others have made it before. I understand that substantive options will be discussed at the next meeting of Greater Glasgow and Clyde NHS Board, which will take place later this month. That discussion will provide the basis for future dialogue with the hospice. Given the imminence of the meeting, I do not think that it would be helpful for me to pre-empt it at this stage. However, I appreciate that members will continue to raise the issue and will want to return to it once the outcome of the meeting is known.

Des McNulty (Labour, Clydebank and Milngavie)

I am sure that the minister is aware that the deadline that was originally set for moving from the current arrangements to new arrangements was 1 April. In that context, would it not be appropriate for a meeting to take place between the hospice and the health board in advance of the board meeting on 24 February, so that the hospice has at least some idea of the proposals that will be brought forward for discussion? That would give us the maximum opportunity for the matter to be resolved successfully.

Nicola Sturgeon (Scottish National Party, Glasgow Govan)

I thank Des McNulty for his suggestion and I acknowledge his interest as the constituency member. I am well aware of the deadline, as is NHS Greater Glasgow and Clyde, and I am sure that it will be in the minds of board members when they discuss the issue on 24 February.

I will pass Des McNulty's suggestion to the health board. There has been considerable dialogue—albeit not dialogue that has resulted in a conclusion—between the health board and the board of St Margaret of Scotland Hospice. The most important next step is for the health board to have the discussion on substantive options that will allow it to formulate its response to the hospice's proposals.

I acknowledge the urgency of the issue, as I have always done. Although members might have different views on the process and some of the issues that are at stake, I think that we are all of one mind in wanting the board and the hospice to reach an outcome that satisfies both sides. I hope that that will happen following the next board meeting.

Gil Paterson (Scottish National Party, West of Scotland)

I spoke to hospice staff recently, who face uncertainty in their workplace and their lives. Will the cabinet secretary use her influence to encourage the board to say what it intends to do and when it intends to do it? If changes are to be made, will she encourage the board to defer them for as long as possible, to give the hospice time to adapt to whatever is suggested?

Nicola Sturgeon (Scottish National Party, Glasgow Govan)

I thank Gil Paterson for his helpful comments. I hope that there will be clarity after the board meeting on 24 February. I will make no comment about blame or who is in the right and who is in the wrong. I genuinely regret that both sides have not been able to reach a conclusion before now, and I hope that clarity is provided on 24 February and that a basis is found on which the matter can be taken forward.

I will ensure that the health board is aware of the comments of members, including Gil Paterson, and I will ensure that it reflects on those comments as part of the discussions that take place later this month.

Hugh O'Donnell (Liberal Democrat, Central Scotland)

To ask the Scottish Executive how many elderly people are in hospital waiting for places in care or nursing homes. (S3O-5912)

Shona Robison (Scottish National Party, Dundee East)

According to the most recently published delayed discharge census, in October 2008, 263 elderly patients in hospital were waiting to move to a care home. Of those patients, 50 were delayed for more than the agreed discharge planning period of six weeks.

Although the level of delayed discharges at the October census was 87 per cent lower than was the case in October 2006, under the previous Administration, the Scottish Government is determined to ensure a positive return to zero as soon as possible.

Hugh O'Donnell (Liberal Democrat, Central Scotland)

It is helpful to know that the Government is still committed to reducing bed blockages, as they are called. I have anecdotal evidence from people throughout Central Scotland who are concerned that a prime difficulty is to do with funding for places. Will the minister give guidance on that and reassure me that she will do what she can to ensure that funding is available to local authorities and other funders to speed up transfers?

Shona Robison (Scottish National Party, Dundee East)

Local authorities have received record levels of funding, which were reflected in yesterday's announcement by the Cabinet Secretary for Finance and Sustainable Growth. Of course, the priority that delayed discharge is given is shared between ourselves and colleagues in local government. I hope that, because of that shared priority and because of the extensive work that is going on between local authorities and health boards to redesign services, to make them more fit for purpose and to ensure that people can have as quick as possible a transition from hospital, not only will there be a return to zero but—this is important—such a position will be sustained. I am confident that the work of local partners will deliver that.

Brian Adam (Scottish National Party, Aberdeen North)

To ask the Scottish Government what guidance it gives to local authorities, police and health authorities on parking rights for health care professionals as part of their duties to deliver care in the community. (S3O-5876)

Nicola Sturgeon (Scottish National Party, Glasgow Govan)

No such guidance has been issued. Local authorities are responsible for the operation of parking controls in their areas. We would, of course, expect a council routinely to work with the relevant health boards to ensure that parking controls support health care workers in delivering care to patients.

Brian Adam (Scottish National Party, Aberdeen North)

Does the cabinet secretary agree that there is a need for a constructive attitude towards the use of residents' car parking spaces and permit-only areas by care-in-the-community health professionals, especially in cities where there is more parking regulation and spaces are scarce, so that those professionals can carry out their jobs in a timely manner?

Nicola Sturgeon (Scottish National Party, Glasgow Govan)

I agree with Brian Adam that there is a need for such a constructive attitude. Community health workers, by definition, travel around to do their job, visiting people in their communities. I encourage all health boards and local authorities to work together as far as possible—acknowledging that demand for parking always outstrips supply—to ensure that the needs of that important group of health workers are properly taken into account. If there are specific issues in Brian Adam's constituency that he wishes to pursue in more detail, I would be happy to consider them.

Marilyn Livingstone (Labour, Kirkcaldy)

To ask the Scottish Executive what resources it will make available to meet the needs of male survivors of childhood sexual abuse in light of the recent research report launched at the turning research into action conference. (S3O-5943)