Scottish Parliament, 26 March 2009

354 contributions from 89 members. The official report.

Official Report 26 March 2009

Health Care

Alex Fergusson (None, Galloway and Upper Nithsdale)

Good morning. The first item of business is a debate on motion S3M-3796, in the name of Mary Scanlon, on the national health service and the independent health care sector.

Mary Scanlon (Conservative, Highlands and Islands)

I welcome the undoubted success of the Scottish regional treatment centre at Stracathro and put on record our congratulations to the previous Liberal and Labour Scottish Executive on setting up that pilot and leading the way with a highly effective partnership between the NHS and the independent health care sector. It is not often that we congratulate, but there we are.

As the motion states, the Stracathro pilot has been rated as excellent by its patients; has reduced waiting times; has had no reported cases of hospital-acquired infection; and has saved more than £2 million for the NHS. For people living in the area, the pilot helped to keep Stracathro hospital open, following a petition to the Parliament with 48,000 signatures. In the past, politicians and others have talked about the NHS and the private sector as two separate entities, which of course they are. However, the difference at Stracathro is that an independent company leases NHS facilities to treat NHS patients at times when the theatres are not being utilised, including outwith normal working hours, during the evenings and weekends, which suits many patients.

The partnership brings money into the NHS through leasing. It has also helped several NHS boards to achieve waiting time targets, allowed better planning for service delivery and cut down on expensive last-minute ad hoc spot purchasing from the private sector. Of course, any failure to deliver surgery and treatments within the timescale results in the independent company, Netcare Healthcare UK, having to undertake the activity free of charge. In the two years from February 2007 to February 2009, almost 5,000 patients from the Forth Valley NHS Board, Grampian NHS Board, Fife NHS Board and Tayside NHS Board areas were treated by Netcare at Stracathro. The system is more efficient and is estimated to provide 11 per cent more value for money than undertaking similar activity in the NHS. A contract variation was agreed with Netcare to reduce treat-by dates from 12 weeks to eight weeks for all activity groups by 28 February this year.

We hear constantly that the NHS should not be in conflict or competition with the independent sector. However, the project illustrates conclusively how the independent sector can complement and work alongside the NHS to benefit NHS patients. No one pays for treatment at Stracathro—the facility is for NHS patients. Another criticism that is often made of the independent sector is that it takes resources from the NHS. However, it was a contractual requirement on Netcare not to recruit staff who had worked locally for the NHS in the previous three months. My colleague Murdo Fraser will expand on that issue of additionality. The contract addresses many of the criticisms that have been made of the independent sector.

Our motion calls on the Scottish Government

"to continue to work with the independent sector ... to deliver the best possible healthcare"

in Scotland. The Scottish Conservatives want to put patients first. We want patients to receive the best-quality treatment in the shortest time that provides the quality of life that they seek. The approach of working with the independent sector includes the service that is provided by Medacs Healthcare, a private company that is based in Leeds and which is the largest supplier of locum doctors to the NHS. The company also provides a full service to the Scottish Prison Service as well as providing forensic medical examiners for detainees, police personnel and victims in Scotland. I made it my business to telephone one or two constabularies and the Scottish Prison Service, which confirmed that they receive an excellent service from Medacs. The good thing is that those organisations can examine their contracts every few years so that anything that is unsatisfactory can be negotiated and put right. The system has worked well to the benefit of people in Scotland.

Another independent company is Atos Healthcare, which operates 31 medical centres in Scotland and employs more than 170 clinical staff here, including doctors and nurses. The company makes recommendations on entitlement to benefits after carrying out medical examinations and reviewing cases. I appreciate that entitlement to benefits is a reserved issue, but I hope that the Scottish National Party will not use forthcoming legislation to ban commercial companies, such as those that provide an excellent service to benefit claimants, the constabulary, the prison service and other organisations throughout the public sector in Scotland.

It is sad—I could use other words, but I will be diplomatic—that the SNP Government undoubtedly puts ideology above patient care. The Government amendment congratulates NHS staff on the excellent work that they do. All members would congratulate all NHS staff on their excellent work, but the Government could find it in itself only to note the role of the private sector staff who treat NHS patients—how shameful. The Labour Party amendment would even delete our tribute to it. My goodness—we are in a consensual Parliament with a minority Government, but when we congratulate our partners in the Labour Party, they attempt to delete our congratulations. However, the Stracathro project is undoubtedly excellent.

The examples of the Scottish regional treatment centre; the medical work for the Scottish Prison Service and the police service; and Atos's work on determining medical fitness in relation to benefits or fitness to work give a taste of the range of excellent work that can be done through the NHS and other organisations working in partnership with the independent sector to deliver the best possible health care for the people of Scotland. That is what the Scottish Conservatives want.

I move,

That the Parliament welcomes the success of the Scottish Regional Treatment Centre at Stracathro and pays tribute to the previous Scottish administration for piloting the scheme; notes that the Stracathro pilot was rated as excellent by its patients and has reduced waiting times, that the centre has no reported healthcare associated infections and that it has saved several million pounds of taxpayers' money in the process of successfully treating NHS patients; further notes that since 1999 successive Scottish administrations have recognised the contribution that can be made by the independent sector to treating NHS patients, with a record 4,409 treatments performed in 2008, more than double the level in 1999 and a 38% increase since 2007, and accordingly urges the Scottish Government to continue to work with the independent sector in order to deliver the best possible healthcare for the people of Scotland.

Shona Robison (Scottish National Party, Dundee East)

I welcome the debate, which gives us the opportunity to restate our policy on the use of the independent sector and to correct the claims that NHS boards' use of the private sector has increased during our period in office. I will come to that in a minute.

Our primary objective is to have a world-class Scottish NHS. We certainly have no policy of investing in independent services at the expense of the NHS. The funds that were voted for by the Parliament for the NHS will be spent by the NHS for the benefit of NHS patients. However, neither do we have a policy of prohibiting NHS boards from using the capacity of the independent sector at the margins when that is demonstrably of benefit to NHS patients and represents value for money.

For example, NHS boards are perfectly free to continue to use the independent sector to help meet short-term pressures and to provide capacity from time to time when that is necessary to treat patients quickly. That will always be at the margins. We use the independent sector on a tactical basis, with long-term investment in the NHS. That is unlike the previous Administration, which made available £45 million over three years specifically to fund and encourage the use of the independent sector. That funding has now been repatriated to NHS boards, which has allowed investment in direct patient care. The investment that we make available will build sustainable services within the NHS. The independent sector will be used tactically, not strategically, on NHS terms and without central pump-priming where funds are used for acute activity in the independent sector.

Let me turn to the statistics. The assertion has been made that official data are showing more use of the independent sector by NHS boards. Members should be aware that only now are procedures that have been taking place in the independent sector being recorded properly. The Information Services Division acknowledges that the published data are incomplete. That is why, last summer, the Cabinet Secretary for Health and Wellbeing specifically required boards to ensure that returns are submitted to ISD Scotland for patients who have been treated in the independent sector.

The figures that have been referred to by the Tories as somehow showing an increased use of independent hospitals include private nursing homes, hospices and other independent providers, including homes run by local authorities and charities. In fact, half of the total figure that was cited in the motion—2,435 out of the 4,409 treatments for 2008—is for non-acute activities. The Tories have got their facts badly wrong, and they have interpreted figures incorrectly, despite the explanatory notes and the written answers that have been given to them, which make that point very clearly.

Mary Scanlon (Conservative, Highlands and Islands)

They are your figures.

Shona Robison (Scottish National Party, Dundee East)

They are our figures—with a very clear explanatory note that members should have read. It would be a mistake to use the welcome increase in local care provision as a means to further the argument that the NHS is increasingly relying on the independent sector for acute activity. Rather, it is clearly consistent with our policy of shifting the balance of care.

A proper analysis of the data that were provided by ISD Scotland shows that NHS boards have recorded a significant downturn in the use of the independent sector for acute hospital activity. The figures show that independent sector acute activity fell by 37 per cent between 2006 and 2008—1,008 episodes in 2008 compared with 1,604 episodes in 2006—notwithstanding the lack of proper recording prior to 2008. It should also be noted that the joint NHS-independent sector facility at Stracathro showed activity of 966 episodes in 2008, compared with none in 2006, which skews the available figures for 2007 and 2008. Figures for core acute activity, leaving aside Stracathro, confirm that NHS boards are not making increased use of the independent hospital sector for acute services.

I acknowledge the contribution that diagnostic and treatment centres can make to reducing patient waiting times. However, that can equally well be done in the NHS. The Stracathro pilot is currently being reviewed by NHS Tayside and its partner boards, which are examining their future capacity needs and are considering the full range of options for Stracathro's use to deliver the best outcome for patient care and the public purse.

Despite the tightest financial settlement from the London Treasury since devolution—

Shona Robison (Scottish National Party, Dundee East)

It is true. Despite that, the Scottish Government has invested more money in the NHS than ever before. We have increased spending on health per head of population to record levels, and we have delivered record investment, which will exceed £11 billion by 2010-11. Capital investment totalling £1.676 billion was made available to NHS Scotland over the period 2008-09 to 2010-11. In 2009-10 and 2010-11, capital resources of £603 million and £548 million respectively have been made available to NHS Scotland. That is a record level of capital funding, which will ensure that the NHS is better equipped and resourced than ever before to improve the quality of the patient and staff environment.

With those words, I am happy to move amendment S3M-3796.3, to leave out from "success" to end and insert:

"Scottish Government's commitment to a mutual NHS in Scotland and its decision only to use the private sector for health provision at the margins where necessary; further welcomes the fact that there has been a 37% drop in private sector acute activity, excluding Stracathro, between 2006 and 2008 and congratulates NHS staff for achieving this reduction; notes the role of the private treatment centre pilot at Stracathro, established by the last administration, and awaits the final evaluation of this pilot, and commends the Scottish Government policy to direct investment into the NHS rather than divert scarce resources into private sector health provision."

Alex Fergusson (None, Galloway and Upper Nithsdale)

The remaining speakers were advised that they would have about four minutes each. I can now advise them that we have a bit of flexibility available, so members should feel free to take interventions if they wish to do so.

Richard Simpson (Labour, Mid Scotland and Fife)

I pay tribute to Mary Scanlon and the Conservative party for lodging this morning's motion, which does, indeed, pay tribute to the previous Administration for commissioning the pilot scheme at Stracathro. That is a rare accolade, and it led me to look a great deal more closely at the evaluation of the Stracathro project. My colleague Helen Eadie will address some of the critical points arising from that evaluation, which were rather skipped over by Mary Scanlon.

David McLetchie (Conservative, Edinburgh Pentlands)

Given that the member's amendment deletes our compliment and tribute to the previous Scottish Executive, can we take it that the new Labour Party is now officially ashamed of its record in Government?

Richard Simpson (Labour, Mid Scotland and Fife)

It will become clear as my speech progresses that we are in no way ashamed of what we did in Government. We are very pragmatic in our approach.

The Scottish regional treatment centre has made a positive contribution for patients. It has reduced waiting times for many patients with painful and debilitating conditions. That success has been achieved by increasing the number of spaces that are available for elective surgery, ensuring that the treatment is efficient and convenient, while maintaining high levels of care. The SRTC allows us to keep open a valued resource at Stracathro hospital—that was a very important factor in the decision that we reached, in response to the campaign in the area to keep the local facility open.

It was Labour's aim over its term in office to utilise the skills and capacity of the private sector to overcome NHS capacity issues on a temporary basis, and I am pleased that the proposals have worked so well at Stracathro. Independent health care organisations can provide great flexibility, particularly by introducing new and innovative care—not that the NHS is bad at introducing that. However, on occasions, it is necessary for us to use the private sector to instigate changes and to ensure adaptation.

Brian Adam (Scottish National Party, Aberdeen North)

Would the member care to spell out a little more where he sees the independent sector's role as being innovative? Can he give us some other examples?

Richard Simpson (Labour, Mid Scotland and Fife)

In a speech of four minutes, I do not have time to do that. There is no doubt, however, that there are areas where it can play a role. For example, the private sector has done work on breast cancer and on infertility. Innovative work has been done in the private sector. That is in no way to detract from the NHS, which has produced the preponderance of innovation, but using the private sector can be very helpful to the NHS when it comes to mass change.

We developed the SRTC to ensure a greater balance of facilities in the east. It was appropriate for people in the west to go to the Golden Jubilee national hospital, and the nationalisation of that establishment was an important factor in creating the necessary capacity.

Nanette Milne (Conservative, North East Scotland)

Will the member take an intervention?

Richard Simpson (Labour, Mid Scotland and Fife)

I have taken enough interventions, and I have to get on—I am sorry.

The Golden Jubilee hospital provides a great resource and provides capacity that boards themselves are unable to provide.

Many patients are still waiting on long lists, with 18 weeks from treatment to the out-patient stage, and 18 weeks from out-patient to treatment. That will change, and there will be capacity needs in future. The Minister for Public Health and Sport has said that the Government will use the independent sector not strategically but tactically, and I understand that, but it will become necessary to ensure that there is adequate capacity to meet the new, very challenging, targets. The use of the private sector will need to continue.

The standards of those independent sector services that we use must be the same as those for the public sector and that is certainly the case at Stracathro. Patients get a choice about the date and time of their initial appointment, which is now usually within six weeks of referral. It is important that it has been possible to achieve that.

Satisfaction ratings exceed 90 per cent for the treatment centre, and the incidence of health care acquired infection is low. I was very impressed with the centre when I toured it, and Tayside NHS Board was pretty satisfied with the treatment available there. Nevertheless, patients still have to travel quite long distances. In the longer term, it will be important to build capacity within the NHS to ensure that that is where the overwhelming majority of procedures are carried out.

Mary Scanlon mentioned Medacs Healthcare, and I am pleased that the prison medical service is to be brought back into the NHS. That is important. A pragmatic decision was made because it was not possible for the NHS to undertake the service as we wanted it to be undertaken. However, it has now been agreed in principle that both nursing and medical services in the prison service will be brought back into the NHS. I hope that that will happen quickly.

Labour will continue to maintain a totally pragmatic approach in which the interests of patients are put first. When we undertake work with the private sector, it will be done entirely on that basis.

The Labour Party will certainly support the Liberal Democrat amendment.

I move amendment S3M-3796.1, to leave out from "and pays" to end and insert:

"with its high level of patient approval and welcomes the Scottish Regional Treatment Centre's contribution to maintaining Stracathro Hospital as both a local and regional resource; notes the success of the nationalisation of the HCI hospital in Clydebank, now the Golden Jubilee National Hospital, and recognises the contribution of both these units and their staff in achieving the continuing reduction in waiting times."

Ross Finnie (Liberal Democrat, West of Scotland)

I listened with great care to the opening speeches from colleagues, and last night I read the motion and the amendments carefully, and I am bound to say that we are conducting a rather artificial debate. If we interpret the English language in the ordinary way, the motion in the name of Mary Scanlon makes no plea at all for an extension or expansion of private medicine in Scotland. It simply acknowledges that a pragmatic approach—to paraphrase the words of Dr Simpson—should be taken to utilising the private sector when it might augment and complement the NHS.

In her opening speech, Mary Scanlon drew attention to three examples of where it has been helpful to take just such a pragmatic approach; and although I understand that we are to hear from Helen Eadie a litany of failures, the wording of Dr Simpson's amendment acknowledges the contribution that such an approach has made. I am sorry for Helen Eadie, because the amendment has put her in an awkward position. But there it is: we all know how difficult it can be when there are internal party difficulties.

The Minister for Public Health and Sport has explained that she does not want any expansion in private provision. The Government has made its position absolutely plain, and I have no qualms about that. The minister has said that services should, in every case in which it is possible, be provided by the national health service. However, she acknowledges that places such as Stracathro might, on the balance of the argument, be able to offer a pragmatic solution. As a result, trying to find differences between the views placed before us is extraordinarily difficult. I have no doubt that, during the rest of this debate, we will turn not so much to simple medicine as to forensic medicine, in order to discern the differences between our positions.

Unlike the Labour Party in its somewhat contorted amendment, the Liberal Democrats have chosen to leave untouched the Conservative motion's gracious tribute to the previous Administration. Such a tribute has happened only once before, so I would be reluctant to delete it from the record. That would be churlish in the extreme.

The position of the Liberal Democrats is clear. We sign up to a health service that is, in essence, run by the national health service. However, we also acknowledge that we are where we are: private providers exist and if the NHS cannot provide a service—as happened in the prison service some years ago, as Richard Simpson pointed out—we have no ideological objection to the use of the private sector for the benefit of patients. However, we say clearly that any use of the private sector must not involve the displacement of people who are involved in or work for the NHS.

In a country the size of Scotland, it can be somewhat false to talk of competition. The competition would have to take place within what is a limited resource—limited both in personnel and in buildings. Having full competition, with all the duplication involved, would not be a sensible way to make progress.

As long as it is understood that the NHS must remain the core of health provision, Liberal Democrats are content that the private sector can have a role. We would do nothing to encourage the expansion of the private sector, and we would certainly not encourage any increase in the capacity of the private sector; but if on occasion the private sector can usefully assist the NHS to the benefit of patients, we are content that that should happen—as long as there is no displacement of staff or resource from the NHS.

I move amendment S3M-3796.2, to insert at end:

", while ensuring that the use of the private sector does not destabilise local NHS provision or undermine the recruitment and retention of NHS staff."

Murdo Fraser (Conservative, Mid Scotland and Fife)

I welcome the opportunity to speak about the success of the Scottish regional treatment centre at Stracathro from a local perspective. Many of my constituents from Mid Scotland and Fife, particularly those from the Tayside and Fife areas, have benefited from the facility, which operates within the independent health care sector.

Stracathro hospital has always been valued by the community in north Angus and the Mearns. Like many local hospitals throughout the country, it developed into a general hospital providing a range of treatments. Situated on a large well-laid-out site at the foot of the Angus glens, it provides an attractive environment for patients and is easily accessible because of its proximity to the A90 dual carriageway. The hospital has also been an important part of the economy in north Angus, providing employment to doctors, nurses and ancillary workers—employment that was often well paid and secure in an area where the main employers were in the fields of tourism and agriculture, where jobs are often low paid.

Like others, I can remember around 10 years ago when there were serious doubts about the future of the hospital at Stracathro. At the time, Tayside NHS Board seemed intent on running down the hospital or even closing it altogether. That would have meant people from north Angus having to travel to Ninewells in Dundee for treatment. Closure would have been a serious loss to the area.

As we have heard, a long and energetic campaign was fought by local activists against the downgrading of Stracathro. In due course, NHS Tayside started to change its mind. An important milestone in the process was the establishment of the regional treatment centre in 2007. As we have heard, that was a decision of the previous Scottish Executive. It is a decision for which I must commend in particular the former Minister for Health and Community Care, Andy Kerr—a man of intelligence and vision. How disappointing it is that the Labour Party amendment seeks to delete our recognition of his success. Perhaps Iain Gray is nervous of praise for his erstwhile leadership challenger.

Understandably, there were some local reservations about a private company coming into Stracathro to provide services, but the creation of the SRTC was nevertheless widely welcomed as representing a substantial new investment in a popular local hospital. As we have already heard from Mary Scanlon, according to PricewaterhouseCoopers there will be a projected saving of £2 million in cash terms to the NHS over the lifetime of the contract. There has also been a positive impact on waiting lists and times; and there has not been a single case of a hospital-acquired infection at the SRTC. Patient satisfaction is very high, with an overall 84 per cent rating.

Shona Robison (Scottish National Party, Dundee East)

Murdo Fraser and I have been party to the detail of the financing of the pilot. Of course, it would not be appropriate for us to discuss that here, because the information was given in confidence, but does he acknowledge that the financing arrangements for a pilot are not necessarily what would be required for wider applications?

Murdo Fraser (Conservative, Mid Scotland and Fife)

When the contract goes out to tender, I dare say that we will find out whether the excellent deal secured by NHS Tayside for the pilot can be repeated. I hope that the SNP Government will not rule out, for ideological reasons, the opportunity to save the taxpayer millions of pounds that could be spent elsewhere in the NHS. The figures speak for themselves and they reflect the high quality of care and the excellent work of the staff at Stracathro.

Opponents of the independent health care sector will often argue that independent facilities will poach NHS staff. That point is covered in Ross Finnie's amendment. The technical term here is "additionality"—in other words, the principle that staff employed in the independent sector should bring additional capacity to the local health care system and should not be recruited at the expense of NHS staffing levels. In its report, PWC found that additionality had not been a significant problem at Stracathro. Part of the reason for that is that the hours operated in the SRTC tend to be outwith normal NHS working hours. As a result, staff are often happy to add to their existing part-time work by also working part-time in the Netcare project. There is therefore no negative impact on the work that people do for the NHS. People are able to enhance their earnings, which puts more money into the local economy. It is a win-win situation all round.

We should not threaten, for ideological reasons, the future of this very welcome project. It has secured the future of Stracathro hospital, and it should continue.

Ian McKee (Scottish National Party, Lothians)

I am sad to say that the Conservative motion is misleading and premature. It is misleading for the reasons that the Minister for Public Health and Sport has already given, and it is premature because the Stracathro treatment centre has not been functioning long enough to allow its success or failure to be properly judged.

There is plenty of evidence from England about similar independent sector treatment centres, as Labour began the experiment there much earlier and it involves greater numbers. In 2007, a Department of Health report claimed that of the £1.4 billion-worth of contracts to English independent sector treatment centres, only £1.18 billion-worth of services and procedures were carried out, but the remaining £222 million still had to be paid to the private sector. Payment was made for nothing, because the contracts obliged payment whether or not any service was provided.

In 2006, English ISTCs were paid for 50,000 operations that never took place—one centre was working to only 5 per cent of capacity. As a result, the second wave of ISTCs in England was drastically pruned, which obliged the Government to pay up to £25 million in bid costs to unsuccessful contractors. That is another case in which NHS money has been spent on nothing.

Derek Brownlee (Conservative, South of Scotland)

Would the member, as a former general practitioner, like to comment on whether the new GP contract is a case of providing money for nothing?

Ian McKee (Scottish National Party, Lothians)

As a former GP, I think that the new GP contract was perhaps the most unsuccessful thing that the Labour Government has ever organised, and it should be completely renegotiated. It is an enormous waste of money.

The problems that have been generated by ISTCs in England are not only financial. The accusations that the centres creamed off the easy cases and left the health service to foot the bill for more complex cases could not be adequately investigated by the Healthcare Commission, as the data from the independent sector was so poor. Most ISTCs did not take part in schemes to train young NHS doctors, so medical education suffered; and there was poor communication between the centres, which meant that transmission of test results and patient notes became more difficult.

It is no wonder that Gwyn Bevan, professor of management science at the London School of Economics, stated last year that even after seven years, there was little hard evidence that any benefit had been derived from that expensive initiative. However, perhaps things are different at Stracathro, and perhaps we have learned those lessons. I hope that that is the case, but there is, as yet, no robust evidence.

The Conservative motion states that the Stracathro centre is

"rated as excellent by its patients",

but it would be surprising if a new centre on which millions of pounds have been lavished—whoever it was provided by—was not welcomed by patients. The PricewaterhouseCoopers survey is very short on methodological detail, and replies were received from only 39 per cent of those who were surveyed. The provision of extra facilities is bound to reduce waiting times, whether those facilities are provided privately or on the NHS.

The motion states that the centre is saving the NHS millions of pounds. However, although the PricewaterhouseCoopers report states that there were 2,200 referrals to the Stracathro regional treatment centre in its first 10 months of operation, the Tayside delivery committee reported on 12 March 2008 that there had been only 1,720 procedures to January 2008 since work began in February 2007, which is a shortfall of 480. It is possible that those procedures were paid for but not carried out—there is certainly such a penalty clause in the Stracathro agreement—and we need to know.

I hope that, one day, the facility—which is paid for from public funds—will be restored to NHS ownership and play its role in serving local communities as an integrated part of the national health service. The truth is that, in England, Labour's flirtation with the independent sector has been nothing short of a disaster. Hospitals have been forced to tender for services that they already provide, but have been prohibited from reducing their charges below an amount that is set by the Government, so they automatically lose the contract. GP practices have been taken over by large private companies against the wishes of the communities that they serve. There are also, of course, the ruinous private finance initiative contracts that have made fortunes for United Kingdom and foreign companies.

I understand the Conservatives' support for that flirtation with the independent sector—it is what they do—but I do not understand the support from those Labour Party members who profess respect for the ideals of Nye Bevan, or from the Liberals who boast about William Beveridge as the true father of the national health service. Those worthy gentlemen must have birled in their graves when Labour and Lib Dem members in this chamber voted in 2004 to promote the private sector.

The NHS is a public service, and the SNP promises the people of Scotland that we will keep it that way. I support the SNP amendment.

Helen Eadie (Labour, Dunfermline East)

It is wrong to rewrite history in any partnership, whether domestic or political. Ross Finnie said that it had been suggested that I would recite a "litany of failures", but Richard Simpson did not say that—he said that I would be "critical" of the failures. As Ross Finnie is always careful about detail, I remind him that that was exactly what was said.

With regard to the petition to keep the hospital open, we should not confuse Stracathro hospital with Netcare. Stracathro, which I have visited, is a very good hospital, but I am not happy with the report on the private company, Netcare Healthcare UK.

In response to Brian Adam's point about the private sector, I tell him—although I see that he has disappeared from the chamber—that as a caring socialist, I would not stand by and watch anyone suffer. To pick up on Ian McKee's point, Nye Bevan and the other pioneers in the movement would never have wanted us to do that—if the capacity was not available in the NHS, they would have wanted us to ensure that we built capacity by using the private sector if that was necessary. I do not have a problem with that.

I say in response to Ross Finnie's point that I always want to ensure that we try to build capacity in the NHS and use the private sector as little as possible. The private sector—if Brian Adam wants an idea of how best to use it—should be used for infertility services. According to one report, patients are waiting up to six years for infertility treatment—the situation is critical, and the Government must do something about it.

It is a revelation that, although the SNP Government claims to be committed to avoiding the use of the private sector, it has in its first 18 months in office delivered a massive expansion in that area. In Fife, only 17 cases were authorised for treatment in the private sector in 1999, but by the end of 2008, that number had risen to 270 patients. In Forth Valley, only three patients were treated by the private sector in 1999, but by the end of 2008, the number had reached 525. In Grampian, only 92 cases were treated in the private sector in 1999, but by the end of 2008 the figure had reached 969. In Tayside, no cases were treated in the private sector in 1999, but by the end of 2007, the sector was treating 426 cases.

Ian McKee (Scottish National Party, Lothians)

Does that not indicate that the Government of the time, which the member supported, did not provide enough NHS facilities and therefore caused the shortfall that required private intervention, which she says should take place only when the NHS cannot provide the services itself?

Helen Eadie (Labour, Dunfermline East)

I ask the member why his party's Government has continued to expand the use of the private sector with great haste and vigour. That just shows that the SNP uses the private sector when it suits, which is a case of duplicity and deceit on a grand scale.

I am sure that other members will be interested to note what is contained in the minute of NHS Tayside's board meeting on 26 June. It states clearly that the director of public health for NHS Tayside, Dr Walker, requested that his dissent be recorded in relation to the value-for-money report by PricewaterhouseCoopers—the 10-month contract review of Netcare's three-year contract. I believe that his dissent was well founded, and anyone who carefully reads the report will see that it raises important questions.

The more I read of the report, the more incredulous I became—it made me raise my eyebrows, sit up and take notice. The figures that are used in the value-for-money assessment are taken from unaudited data sets, and no attempt has been made to verify or audit data sources. Astonishingly—and worryingly for the Scottish taxpayer—the contract requires that the NHS pay "unavoidable costs" in respect of any underreferral below the agreed threshold of 90 per cent. The figures to September 2007 show £139,000-worth of underreferral charges for that period, of which £128,000 was for "unavoidable costs"—as stated in the contract—that are required to be paid to Netcare in respect of activity that has not been undertaken.

If we seek to analyse the structural reasons why the NHS is more expensive—a figure of £2 million has been mentioned by the Tories—we need only consider the following to see how the dice are, as ever, loaded against the NHS. The report states:

"the SRTC has acceptance criteria meaning that clinically unstable patients, or those with significant co-morbidities are unlikely to be referred. This gives an overall more efficient and safe service appropriate for its setting but would, on average, lead to a lower cost per activity than in the NHS."

The report also states:

"Post operative quality of major joints is unproven at this stage."

In addition, the report shows that the patient satisfaction survey response rate was low—39 per cent is not excellent—which Mary Scanlon should acknowledge.

Financial records—including audited and unaudited accounts for the service provider—and any related reports should be made available, but such records have not yet been provided, or even requested. Initial difficulties with Netcare's management systems for collecting, processing and delivering the required information have meant that a degree of prompting by the NHS has been necessary to obtain that information. The fact that Netcare has changed management teams three times since the start of the pilot has created instability.

As if all that was not bad enough, the report goes on to say:

"We have not reviewed and therefore do not make comment on the completeness of any legal documentation, in relation to health and safety, insurance and any necessary registrations, warranties and licences which are assumed to be in place."

Frankly, I would make no such assumptions—

Alex Fergusson (None, Galloway and Upper Nithsdale)

You must close now.

Helen Eadie (Labour, Dunfermline East)

I would make no such assumptions, most especially on health and safety and insurance. I would want to be absolutely certain.

Andrew Welsh (Scottish National Party, Angus)

Stracathro hospital is an ideal setting for patient treatment and recuperation, with an excellent and dedicated workforce. Historically, the hospital has treated NHS patients not only from Angus but from a much wider—indeed national—catchment area.

The hospital is important not only as an excellent medical facility but as an essential provider of employment in Angus and the Mearns that contributes to maintaining educational and other public services in the local area. That is why I fought to save Stracathro from threatened closure and why I have visited and welcomed the new Scottish regional treatment centre. The SRTC is part of the new growth of services at Stracathro—growth that is essential to ensure the hospital's future as part of the overall NHS hospitals system in Angus and Tayside.

Although the Tory motion is correct to state that the pilot project has added value to NHS services, any attempt to turn a specific, highly specialised, excellent but limited service into a whole new generalised national system would be a very different proposal. Such attempts elsewhere have led to public bail-outs of private facilities, which were not capable of dealing with wider workloads. Where justified by results, the two-year pilot project should rightly be praised for its contribution. However, to claim that the pilot should be extended to the whole NHS system or become the basis of our national system is simply dangerous dogma.

Mary Scanlon (Conservative, Highlands and Islands)

Where do we propose to extend the SRTC pilot to the NHS across Scotland? Can the member provide a reference for that?

Andrew Welsh (Scottish National Party, Angus)

I refer the member to Mrs Thatcher—I had the misfortune of watching her in action—who tried that before. I remember the real consequences of her attitude: NHS cutbacks and closures. I remember the campaigns to save Arbroath infirmary and Stracathro hospital as well as other NHS services. The Tory philosophy leads to privatisation by stealth and should be opposed.

The real long-term answer to NHS improvement is the SNP Government's action in strengthening our national health service system. We need a system that is available to all and which is supported by its professionals and workers. The SNP rejects utterly any idea of an exclusive, cheque-book health care system that is based on profit rather than on need.

The challenge of providing better, faster, more local and more flexible access to health care is, by definition, on-going, but Scotland's greatest challenge is in tackling health inequalities nationwide. Private facilities are a useful addition where they can be proven to be effective, but they do not address that wider problem. The Tory motion certainly does not address that point either.

The primary objective should be to grow NHS capacity by building on the Scottish Government's increase in health spending of 13 per cent over three years, taking the total NHS budget to £11.5 billion. The objective should be to strengthen and build our national system rather than to privatise it. Such public investment in, and commitment to, our national health service is the way forward. We do not need any large-scale farming out of core services to the exclusive private health care industry. That is the underlying subtext of the Tories' attitude and of the motion. They might not state that, but we know their history and we should be wary of it. There are few things worse than unrepentant Tories, but we obviously have a few here this morning. Clearly, the Tories have failed to learn anything from their mistakes. I will most certainly support the SNP amendment.

James Kelly (Labour, Glasgow Rutherglen)

I welcome the opportunity to speak in this morning's debate on the NHS and the independent sector. Before I turn to the substance of Mary Scanlon's motion, I pay tribute to her for the amount of work that she does on health and other issues in the Parliament. She really is a credit to the Conservative group.

The motion deals with the NHS and the independent sector by making specific reference to the success of the Scottish regional treatment centre at Stracathro hospital. When that centre was opened in 2006, it was welcomed by Shona Robison, who represents the SNP on the front bench today. At the time, the centre was put forward as a solution that would meet local needs. Stracathro has been successful in reducing waiting times and helping patients, so, from that point of view, it is to be complimented.

As well as that solution for the east of Scotland, the Labour amendment refers to a solution that was used in the west of Scotland, where the Golden Jubilee hospital was taken into NHS control. The Golden Jubilee is becoming a very modern hospital.

Nanette Milne (Conservative, North East Scotland)

Does the member acknowledge that the NHS could have used those facilities for its patients without buying the hospital from the private sector? Does he accept that it would have been better to use that money—I recollect that it was at least £35 million—for front-line services?

James Kelly (Labour, Glasgow Rutherglen)

Given the Golden Jubilee hospital's development since that decision was taken, there is no doubt that patients feel that the decision was worth while. There have been practical benefits and improvements in health care for those who have attended the Golden Jubilee hospital in Clydebank. Indeed, given that one of the big issues in the west of Scotland is heart disease, the west of Scotland has benefited from having such a facility under public control.

On the challenges facing the NHS, given the importance of achieving what the Conservative motion refers to as

"the best possible healthcare for the people of Scotland",

there is no doubt that the issues that the Parliament needs to face up to include not just health inequalities—that is, how we improve access for all—but the treatment of cancer patients. Along with clinicians, patients and other MSPs, I attended the Scotland against cancer conference in Glasgow last Friday. In a number of presentations and workshops, we heard people speak about the important issues of diagnosis, treatment and lifestyle choices. There is also no doubt that, in coming up with solutions to address the issues raised in those workshops, we need to remember the importance of retaining staff and expertise within the NHS. That point is acknowledged in the Liberal Democrats' amendment.

The fact that a third of the Scottish budget—more than £10 billion—is at the disposal of health and wellbeing shows the size not only of the resources at our disposal but of the issues that we face. In deploying that budget, the default position should be to retain a publicly funded NHS. However, given the challenges that we face, I acknowledge that we should not be completely inflexible. In instances such as the Scottish regional treatment centre, we should consider other mechanisms.

We must put patients first. The NHS—Nye Bevan's tremendous creation—was 60 last year. We must maintain it, consolidate it and build on it, ensuring that we give the NHS another successful 60 years.

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

My colleague Ross Finnie referred to the debate as being "rather artificial". However, some of the main threads have become apparent. I associate myself with his remark that there is no plea in the Conservative motion for an increase in private medicine in Scotland. I back him when he says that there should be no displacement of NHS services. Full competition and duplication are simply not the way forward.

There is perhaps broad consensus among members on that.

Mary Scanlon was ably supported by a splendid backing chorus—the choreography and timing were impeccable. The Conservatives clearly have an excellent artistic director. I pay tribute to the number of Tories who managed to rise out of their beds in good time to join us.

David McLetchie (Conservative, Edinburgh Pentlands)

Unlike our colleagues, the Liberal Democrats.

Ross Finnie (Liberal Democrat, West of Scotland)

We have more sense.

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

I will stick to the main subject of the debate.

Mary Scanlon wisely referred to benefit claimants. We sometimes forget, in our devolved Parliament, that the issue can affect Scotland's revenue stream. We should always keep an eye on that.

I liked Shona Robison's expression that we should use the private sector "tactically, not strategically". That is the right approach. She used the mantra "the tightest settlement", which her master has been using and which he has instructed all SNP members to use. I think that we will hear more of it. We might debate whether the settlement is the tightest yet or whether, in fact, it is the most generous yet. There would be some mileage in having that debate.

I admonish Andrew Welsh for frightening members by summoning up a ghost from the past—but the past it is. I believe that she was on television last night, and I am sure that we wish the grand old baroness the best of health.

Ian McKee and Helen Eadie gave us what was probably one of the more extreme views in the debate. However, it was a timely reminder—indeed a stark warning—of some of the possible problems. The missing figures—the difference between 2,200 procedures and 1,720—is a very curious issue. An audit is essential to find out where the money has gone. As long as such discrepancies exist, doubt is cast on any evaluation of what is being delivered at Stracathro.

Murdo Fraser and Andrew Welsh's point about employment is hugely important and should not be forgotten. In my and Mary Scanlon's part of the world, the delivery of quality jobs—for instance, at Caithness general hospital, where consultants deliver maternity and other services—brings cash into the local economy. That may be a side factor, but it is a factor that should not be forgotten during the current recession. I have no doubt that that is an important aspect of Stracathro.

Helen Eadie (Labour, Dunfermline East)

Jamie Stone talked about my and Ian McKee's extreme views. Is he therefore saying that the views that I referred to, which were the views of PricewaterhouseCoopers, are extreme?

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

Perhaps the word "extreme" was wrong, but there was a lot of colour in what the members said, and it may have been a reminder to them of a proper attitude that we would be unwise to forget. The challenge to us from Helen Eadie and Dr McKee to check and evaluate was entirely appropriate.

Mary Scanlon (Conservative, Highlands and Islands)

Will the member give way?

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

No. I really must conclude now.

Dr Simpson was challenged in an intervention to give examples of where the private sector has delivered, and he was correct to mention the treatment of breast cancer and infertility. Although the private sector has a role, I go back to what Ross Finnie said, which is that my party does not seek to displace NHS services. I very much associate myself with the minister's language: the use of the private sector should be "tactical, not strategic".

I support the amendment in Mr Finnie's name.

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

Ross Finnie began his speech by saying that, given the wording in the motion, the debate was "rather artificial"; nonetheless, it has been interesting, not least because I do not think that I have, in recent times, heard so many tributes paid to the former Executive by the Conservatives. Forgive me if I feel ever so slightly suspicious of Tories bearing gifts.

Mary Scanlon was praised by my colleague James Kelly for all her work on health. I add my thanks to her for that. However, I am perhaps slightly more suspicious than James Kelly—Jamie Stone referred to a choreographed chorus line, and the Conservatives have indeed been pretty well choreographed so far this morning. However, we have not heard the wind-up speech yet, and it may well be a wind-up, depending on what the Conservative member who sums up has to say to us.

David McLetchie asked whether we deleted all reference to the previous Executive in our amendment because we were unhappy with its record. I shall be very clear on that. We have no difficulty with the record of the previous Executive; indeed, our amendment seeks to get on the record our pride in taking the former Health Care International hospital—now the Golden Jubilee—back into the NHS. That important step has been, as James Kelly outlined, of great benefit to patients. I put on record my thanks to Malcolm Chisholm for all his work on that.

Further, I recall a number of occasions on which we were accused of lodging self-congratulatory motions when we were in government. I hope that the Tories will accept that this morning we are being slightly modest by not only seeking to gain plaudits for what we did in the past but looking to the future.

It is a fundamental principle of the NHS that it should provide everyone with the best possible treatment, irrespective of ability to pay. That is why the Labour Party is so determined to ensure that the NHS's fundamental principles remain. That means that we should scrutinise everything in detail. We welcome the pilot and want to ensure that it goes ahead, not least to keep Stracathro hospital open, providing that local service. However, Helen Eadie and Ian McKee raised the issue of looking in more detail at the results of the pilot. That is a fair point.

Mary Scanlon referred to the position of other forms of independent health care provision in the NHS, such as locum doctors and work with the Scottish Prison Service. Like Richard Simpson, I am pleased that the health services that will in future be provided to the SPS will come back into NHS provision.

Mary Scanlon (Conservative, Highlands and Islands)

They are not all coming back into the NHS. In fact, Northern Constabulary has just signed another contract with Medacs. I think that Atos, too, provides a good service. Helen Eadie and Ian McKee did not mention the fact that Netcare had to provide £112,000 of activity free of charge due to contracted waiting time breaches. The figures are not all one way.

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

I am sure that Helen Eadie and others will scrutinise that in detail.

I say to the minister that the trade union Unison is concerned about the continued use of agency and bank staff to fill shortages and vacancies in the NHS, especially as some of them are on zero-hours contracts. I hope that we can address that in the future.

I want to correct a misunderstanding—if such it was—by Mary Scanlon, who suggested that our amendment deletes all references to supporting or recognising the value of the staff at Stracathro. In fact, it does not do that; it ensures that we recognise the value of the staff at both Stracathro and the Golden Jubilee hospital. We have also said that we will support the Liberal Democrat amendment.

Mary Scanlon (Conservative, Highlands and Islands)

It is important that I put on record the fact that I commented on the SNP's amendment, which "congratulates" NHS staff on their treatment of NHS patients but only "notes" the role of private sector staff in treating NHS patients. I made no reference to the Labour amendment in that context.

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

That is a helpful clarification. If there was no intention to criticise the Labour amendment, I hope that the Conservatives might consider supporting it.

Murdo Fraser suggested that ideology should not threaten Stracathro. I would argue that ideology should not threaten the national health service. It is the jewel in the crown and something of which the Labour Party is extremely proud, having developed it. Of course we want it to continue as the way in which we provide services for the vast majority of our patients.

Shona Robison (Scottish National Party, Dundee East)

This has been an interesting debate. The most revealing aspect of it has been the slightly confused and uncomfortable position of Labour members, as reflected in their speeches, some of which had a history-starts-today feel about them.

Our position is clear, as set out in "Better Health, Better Care: Action Plan", which stresses public ownership through a more mutual approach, distancing the NHS in Scotland still further from what we would describe as the divisive market-oriented models that are favoured by some members. That document confirms the NHS's place as a public service that is delivered in partnership with the public.

We have made it clear that we are committed to investing taxpayers' money in the NHS rather than in building up private sector capacity. However, we have no difficulty with NHS boards using existing independent sector capacity at the margins for the benefit of NHS patients, although any use of the private sector by boards will continue to be minimal.

I correct Helen Eadie, who clearly did not listen to a word that I said in my opening speech. The statistics that she cited were based on a false premise. She did not mention the fact that half the figures that she was using included the figures for private nursing homes and care homes that are run by local authorities, charities and hospices. I say to her that the figures for acute activity—leaving aside Stracathro, on which she clearly has her own views—show a 37 per cent reduction in the use of the private sector between 2006 and 2008.

We continue to provide increased resources to enable NHS boards to invest in their infrastructure, which supports the delivery of modern health care services. By allocating resources directly to NHS boards, we are ensuring both that local priorities can be addressed and that there is consistency with national and regional planning agendas. For example, in November 2007 and January 2008, the Golden Jubilee hospital successfully opened two new dedicated orthopaedic theatres. That has enabled the hospital to increase the number of major joint replacement operations by around 1,000, taking the total capacity to around 2,500 hip and knee replacement operations. In addition, a range of minor procedures is undertaken each year. That benefits patients from throughout Scotland. It is now one of the biggest such units in Scotland. Also, last April, we announced £550 million of additional funding towards the development of the new Southern hospitals project in Glasgow, which incorporates the new 240-bed children's hospital.

NHS boards are also making resources available to expand services from their capital and revenue allocations. Examples of that include the extension to Ayrshire community hospital out-patient department; the creation of a new endoscopy suite at Borders general hospital; and an upgrade of X-ray and computed tomography facilities and the creation of a new magnetic resonance imaging suite in Dumfries and Galloway. That move enabled the repatriation of a significant contract from the independent sector in July 2008. Those developments are all aimed at ensuring that NHS boards are expanding their services to meet their populations' needs.

However, the NHS is not about adding new capacity without making best use of existing resources. Initiatives such as lean in Lothian have released significant additional resources for investment in front-line services, which is reflected in increasing activity. The overall number of procedures undertaken in NHS acute hospitals increased by more than 27,000 in 2007-08 compared with the previous year. All of that is leading to the success of the NHS in delivering significant reductions in waiting times. No doubt, we will have a further opportunity to discuss that in next week's debate. I look forward to highlighting the achievements of the NHS in reducing waiting times in that debate.

We are very pleased that there are now more doctors, nurses and allied health professionals working in Scotland than ever before. The total number of staff who are employed by the NHS in Scotland has increased by more than 2 per cent, bringing the head count to more than 165,000 at September 2008. That figure includes a significant increase in the number of medical staff. The actions that are being taken by the Government and by NHS boards clearly show that the health service is well equipped to meet the needs and expectations of the people of Scotland.

Jackson Carlaw (Conservative, West of Scotland)

I thank all members for what has been a good-humoured debate. More than on any other issue relating to the future of health care in Scotland, we take a different view from the Government in our readiness to work enthusiastically with the independent sector to the benefit of the NHS.

Although the independent sector works at the margins in providing health care to a country that for 60 years has benefited from its NHS, we have never believed that those who work in the independent sector—whether as nurses, doctors or auxiliary workers—are any less committed to the care of their patients, any less hard working or any less deserving of our support, gratitude and praise. They are not second-class health workers but first-class health professionals, so the contempt of the rhetoric that has been thoughtlessly directed at them is unworthy and misplaced.

The inherent hostility of the SNP towards the independent sector is well documented. It is worn brazenly as a badge of honour, yet contradicted every day by the Government's actions. As the debate has illustrated, it is precisely because the SNP in government has recognised the opportunity that the independent sector presents to offer a better service to NHS patients that more NHS patients than at any time since devolution are being treated by the independent sector. The most dramatic increase has taken place since the SNP Government came into office.

Shona Robison (Scottish National Party, Dundee East)

Will the member give way on that point?

Jackson Carlaw (Conservative, West of Scotland)

No, I will not give way on that point, because I know that the minister would repeat the same dull statistic that she gave us before, which selectively slices away all the patients to whom she does not care to refer.

No doubt, all of that explains the diplomatic absence of the Cabinet Secretary for Health and Wellbeing from the chamber this morning—blushes have been spared.

Andrew Welsh told us that, despite the Stracathro pilot being an undoubted success, we should dismiss it out of hand because, 19 years ago, the Conservative Party was led by Margaret Thatcher. I am sure that that will be a great comfort to the staff at Stracathro.

I recognise ministers' mealy-mouthed acceptance of the fact that the independent sector can be used almost as a disposable asset whose primary role is to improve treatment waiting times, not for the sake of patients but to add to the spin that polishes ministers' haloes when they take the credit for waiting time reductions. However, that is poor reward. Today offered ministers the opportunity to be a bit more fulsome in their thanks and tributes to those in the independent sector who work as hard as anyone else; yet, as Mary Scanlon observed, the most that they could find it within themselves to do was to note those people's contribution.

I find the Government's hostility to the independent sector perplexing. We are talking about a very practical partnership that was established at Stracathro by Andy Kerr under the previous Executive. It is a bold initiative from which Richard Simpson and Cathy Jamieson have sought to distance themselves this morning by deleting the fulsome tribute that we are prepared to offer. Perhaps in disavowing Andy Kerr's record as health minister they will also accept the mistake that he made in proposing to close accident and emergency facilities throughout Scotland.

The pilot had a clear intention, which was to consider the potential additional use to which NHS operating theatres could be put when they were not being used by the NHS. Dr Ian McKee advised us that two years was not long enough to judge the success of the pilot. I assume, therefore, that he is similarly unconvinced about the success of the SNP Government after just two years. On that, at least, I think that the chamber is agreed.

By any standard, the Stracathro pilot has been a success. We have heard how it has performed operations successfully at a cost of some £2 million less than the NHS. We have heard about the outstanding patient satisfaction. Those patients would probably also be concerned about any creeping privatisation of the NHS. However, having benefited from the treatment that they have received, they can also see that a practical partnership with the independent sector that is designed to benefit the NHS makes political sense.

We can celebrate, too, the record at Stracathro of no hospital-acquired infections. I imagine that a number of us have visited the hospital and have seen for ourselves the commitment of those involved.

The model has worked. Given that, why would any Government not wish to do for patients across Scotland what is being done for patients in Tayside, Grampian and Fife? This Government, however, positively sizzles at the very presence of the independent sector, as is witnessed elsewhere by its determination to end all contracted-out cleaning, allegedly to improve performance in tackling health care acquired infections, even though the worst example of deaths due to an outbreak of Clostridium difficile occurred at a hospital that had in-house cleaning and, in any event, the reasons for the outbreak were complicated and extensive and the outbreak was certainly not simply the responsibility of the in-house cleaning team.

We have a Government that has used the independent sector to provide more treatments to NHS patients than any other Government and has inherited a pilot that is supported by all of the other parties in the chamber and is proving to be a success.

We call on the Government to shelve its caustic rhetoric, to recognise the outstanding incremental contribution that the independent sector has made and to set aside its misplaced prejudice against anyone outside of the NHS who might have a contribution to make. We are not asking the Government to set aside for one moment its commitment to the NHS or to the many worthwhile improvements that it has embarked on; we are asking only that it bury its dogma and put the interests of patients first. Perhaps we are asking for too much, though. SNP dogma will disadvantage patients in Scotland, which is surely the most damning indictment of all.

Alcohol Strategy

Trish Godman (Labour, West Renfrewshire)

The next item of business is a debate on motion S3M-3778, in the name of Bill Aitken, on alcohol strategy.

Bill Aitken (Conservative, Glasgow)

I rise to speak to a motion on a debate that has been running for some months. In one respect, at least, we are making progress. Only two days ago, the Government seemed determined to railroad its measures through the Parliament in subordinate legislation regulations, but it has now thought better of following that anti-democratic line. I have to say that not since Saul went on his celebrated excursion to Damascus has there been such a conversion. Indeed, some might think that it is a deathbed conversion.

Having dealt with the process, we now need to deal with the practicalities. We should start on the basis of a common agreement not that Scotland's relationship with alcohol is problematical, but that some people's relationship is highly problematical and that we require to apply our minds to ways of resolving or at least improving the situation. That will not be done by taking a scattergun approach. We need to consider seriously whether we are using all available tools prior to considering further measures.

The one truth is that the existing law is not being applied with the necessary vigour. It is an offence to serve drink to people under the age of 18 and it is an offence for those under that age to seek to purchase drink. It is an offence to enter licensed premises while drunk or to be in licensed premises while drunk, and it is an offence to serve a drunk person. The number of prosecutions for those offences has been derisory, and only with test purchasing have any significant moves been made to combat underage drinking and the difficulties that it causes.

The weak approach that has been adopted by licensing boards has not helped. Sellers who persistently or recklessly sell drink to young people should forfeit their licence. Licensing boards require to get real. However, licensing boards do not need to have the buck passed to them by the Scottish Government, which is what is happening with regard to the ban on 18 to 21-year-olds buying drink from off-sales premises. That crass policy should be scrapped, and the aim of imposing that duty on local authorities is a device simply to keep face rather than to recognise the reality.

We need to consider how we can get all agencies and the public to co-operate. Some excellent work has already been done by the licensed trade in combating underage drinking, but more needs to be done. We are attracted to the community alcohol partnerships that have been piloted down south, particularly in Cambridgeshire, where information sharing between off-trade retailers, the police and trading standards officers has made a significant contribution. For example, in St Neots, it has delivered a 42 per cent decrease in antisocial behaviour incidents over a six-month period. The way forward is through cooperation, not diktat.

We have to recognise that problematical drinkers in Scotland represent a minority of the population, and we must take action that is properly targeted and effective.

"We do not want the responsible, sensible majority of moderate drinkers to have to pay more or suffer as a result of the excesses of a small minority."

In that respect, I do not claim that the Conservatives have the monopoly of wisdom on this matter. Indeed, I am prepared to accept that there might be some criticism of the words that I have just used and that they might lack the eloquent phrasing and clarity of expression that one would expect from a speaker from this side of the chamber. However, they are the precise words that Gordon Brown used last Monday morning at a press conference in Downing Street. My authority for that is no less an organ than The Guardian, which, as people such as Cathy Jamieson might expect, is not my preferred reading.

Shona Robison (Scottish National Party, Dundee East)

Does the member recognise the worryingly high level of people who consistently drink more than the recommended limits? Does he think that that is a problem or not?

Bill Aitken (Conservative, Glasgow)

I think that it is a problem, and that those are the people who require to be targeted. We must target the problem drinkers and the problem drinks. We can target the problem drinkers, as is happening in Glasgow, by an approach that uses much more hands-on policing and involves licensed premises being visited with the aim of ensuring that the existing laws are obeyed in full. We can deal with the problem drinks by working with the Westminster Government to increase tax on some of the products that do the most damage, such as super-strength ciders and beers. Targeted duty changes are the answer, not across-the-board price increases.

The Scottish Government has got it all wrong. In formulating an alcohol policy, we should work with the trade and the public, insist that the police and the Procurator Fiscal Service play their part, and let the public see for once that we are attacking those who are the source of the problem and not attempting to deal with the matter in an unrealistic and simplistic manner.

The health service has a role to play, and we have to ensure that there is greater education in schools. We have to offer alcohol counselling to those who are admitted to accident and emergency units as a result of alcohol incidents, and we have to encourage the drink trade to ensure that 125ml glasses, for example, are provided. However, above all, we have to recognise that only by working together are we going to get the result that we all seek to achieve. We cannot rule by diktat.

I move,

That the Parliament welcomes the decision of the Scottish Government to incorporate its proposals for reform of the law relating to the sale of alcohol into a new health Bill, which will facilitate democratic accountability and greater parliamentary and public scrutiny of its proposals; calls on the Scottish Government to place greater emphasis on a much more rigorous application of the existing licensing laws and to recognise that any changes can be introduced only on the basis of a wider and meaningful consultation with the licensed trade and Scotland's communities, and believes that any measures taken to tackle binge drinking and underage drinking must be properly targeted and effective so that the responsible, sensible majority of moderate drinkers do not have to pay more or suffer as a result of the excesses of a small minority.

Nicola Sturgeon (Scottish National Party, Glasgow Govan)

I do not know whether the Tories were trying to be helpful—I suspect not—but I welcome this debate, because it gives us an opportunity to reflect on the scale of the problem and set out our determination to show bold and clear leadership.

Members might want to reflect on the fact that today is the third anniversary of the ban on smoking in public spaces, which is a perfect example of what can be achieved when parties are prepared to come together and show collective leadership. However, I am sure that the fact that the Tories initially opposed that progressive social change as well will not be lost on anyone.

There is no doubt that alcohol misuse is holding us back. As today's Audit Scotland report reminds us, it is costing us £2.25 billion a year—a staggering figure that amounts to £500 for every adult in the country. However, the human cost in health harms is even more alarming. More than 40,000 hospital admissions a year are due to alcohol-related illness and injury, and we have one of the fastest growing rates of liver disease and cirrhosis in the world. We have a major health issue on our hands, and it ranges across social groups and ages. The Tories must recognise the number of people who regularly exceed the recommended limits and acknowledge that that is not just a minority problem. We all have a responsibility to tackle the issue. The question is how we do that. As our alcohol framework makes clear, cultural change, education, preventive measures and better treatment and support are all essential. Indeed, only within that broader context will the more far-reaching measures that we propose be effective.

It is also right to say that we should focus more on ensuring that there is better enforcement of the current laws, and we are doing that. The test purchasing programme has already resulted in a tightening up of sales to underage young people. That work is continuing and it will be reinforced as the licensing regime comes fully into force in September with the mandatory "no proof of age, no sale" provisions. We will monitor the effectiveness of the new regime and continue to work closely with stakeholders, including the licensed trade, to identify what more we can do.

However, given the scale of the problem, we believe that we must go further. That is why we set out such a far-reaching range of proposals in our framework—a ban on promotions, a duty on licensing boards to consider increasing the off-sales age to 21 and a right for the police to ask them to do so, a social responsibility fee for some retailers, and, yes, minimum pricing for alcohol.

Mike Rumbles (Liberal Democrat, West Aberdeenshire and Kincardine)

The minister mentioned the proposal to ban off-sales to under-21s. She made the point that there was cross-party support for the smoking legislation and that the Parliament's voice was known. The Parliament has made its voice known on the proposal on under-21s, but the Government is not listening.

Nicola Sturgeon (Scottish National Party, Glasgow Govan)

I did mention that proposal. If Mike Rumbles reads our framework, he will see that we have listened and substantially modified the proposal. People have a duty to reflect on that.

I will say a little about minimum pricing. We are convinced that we need to tackle pocket-money prices. The evidence shows that increases in health harms are driven by increased consumption, which in turn is driven by price. Alcohol is nearly 70 per cent more affordable than it was in 1980 and consumption has increased by about 20 per cent since then. There have been claims, mostly from the alcohol industry, that a minimum price would be illegal, but those claims are unsubstantiated, because they lack detail and a crucial piece of information—that is, what the minimum price would be. As the Parliament would expect, we have carefully considered the legal issues and will continue to do so as the proposal is taken forward. We want it to succeed, which means we must do things properly and carefully.

We have also heard claims that minimum pricing will hit the majority of responsible drinkers in their pockets and punish them for the habits of a minority, but the products that will be most affected are the low-cost, high-alcohol products, which tend not to be consumed by moderate drinkers. That is why the research on minimum pricing shows that a minimum price of 40p a unit would require moderate drinkers to spend, perhaps, only an extra 11p a week.

We believe that minimum pricing has a big part to play, but we also recognise that, on this issue, as on all our proposals, we have a need and a duty to take people with us as far as we can. We are a minority Government, and I therefore recognise the need to work with other parties in the Parliament. Our willingness to listen to others' views was, I hope, well demonstrated this week by our decision on the parliamentary route that we intend to take for our reforms. We will now bring the measures together in a single health bill to be introduced later in the year. The bill will include the full package of reforms that we outlined in our framework and it will allow for extensive scrutiny and debate.

Let me be clear: I want to work with others, but for that approach to be productive it requires other parties also to be prepared to act. To that end, I welcome Labour's indication earlier this week that it will support some of our key proposals. I hope that we can make some common cause with the Liberals and even with the Tories. However, let me also be clear that the bottom line is that the Government is determined to show leadership. We believe that our package of measures provides the bold but effective response that is required to tackle what has become a major health challenge for Scotland, and a challenge that we believe everybody in the Parliament has a responsibility to face up to and meet.

I move amendment S3M-3778.2, to leave out from "binge drinking" to end and insert:

"harmful drinking and underage drinking must be workable and properly targeted so that, while the responsible, sensible majority of moderate drinkers are not unnecessarily penalised, wider issues of excess consumption contributing to huge costs to Scottish society are effectively addressed."

Robert Brown (Liberal Democrat, Glasgow)

This is an important debate in terms of its merits and the Parliamentary issues that lie behind it.

The Scottish National Party Government has rightly identified the problem of alcohol—Scotland's shame, one might say—as a key challenge. It is interesting that we now have "bold" policies in the health realm and "tough" policies in the justice realm. One sometimes wonders whether the words and the presentation are more important than the substance. The reality is that the SNP Government has made a right hash of putting in place the policies to tackle the problem of alcohol. It is rightly inspired by what happened with the smoking ban, but its search for a totemic idea first led it to suggest that young people were the heart of the problem and that all would be well if the age for the purchase of alcohol from off-sales premises was increased to 21. At that point, everyone in sight rounded on the Cabinet Secretary for Justice, including the trade, the public and even the youth wing of his party. The policy was clearly a dead-parrot policy.

Attention then switched to his other big idea, which was minimum pricing. Unfortunately, he had the clever wheeze of trying to slip the measure through the Parliament in subordinate legislation rather than exposing it to public and parliamentary scrutiny. That was a constitutional outrage that undermined the whole point of having a Scottish Parliament. The policy had other problems, too. No details were produced of how it would work.

Nicola Sturgeon (Scottish National Party, Glasgow Govan)

Now that we have got the process argument out of the way, I wonder whether the Liberal Democrats will tell us where they stand on minimum pricing. Does Robert Brown believe that Nick Clegg, Chris Huhne and the Liberal Democrat health spokesman at Westminster are wrong to support minimum pricing?

Robert Brown (Liberal Democrat, Glasgow)

I was going to give some of the background to the matter. We are talking about the problems with the SNP Government's policy.

We do not have the details of the minimum pricing policy, but the examples suggest that it would hit the Scottish whisky industry at home and abroad. It seems that the general public would pay for the policy, yet one study predicts that it would change the drinking levels of hardened drinkers by only 2.3 per cent. That is hardly the totemic answer. The SNP Government has managed to produce not bold and clear leadership, as the cabinet secretary suggested, but a mix of policies that will cause the maximum controversy and hit the average citizen and many businesses hard with both higher costs at a time of great economic crisis and greatly increased bureaucracy. The policies seem likely to have the least beneficial effect.

However, I am sure that the Parliament will want to give credit to the SNP Government for bowing, if belatedly, to the criticism that has been levied at the process and announcing that it will proceed by way of a health bill in the autumn, thus meeting the demand that I made of it in my motion on 9 March. Why it did not do that in the first place is, frankly, beyond my comprehension. The result is that, for the second week in a row, an Opposition motion has been pre-empted by an SNP Government strike. Last week, that involved Labour and police numbers—again, the Cabinet Secretary for Justice was involved—and this week it is the Tories and alcohol. That is clever politics but poor statesmanship. The manoeuvres reveal growing problems at the heart of the SNP Government.

Let us examine the position further. The Cabinet Secretary for Justice's position on police numbers has been all over the place. He is the grand old Duke of York of police numbers, marching his troops up and down various hills to no good effect. The cabinet secretary got his fingers burned on a legislative consent motion on data sharing under the Coroners and Justice Bill. He appeared not to have read the documents and was ready to surrender wide-ranging powers to Westminster. At best, he had not recognised the obvious scorpions that were lurking in the grass. He has now been relieved of control over a key policy that he had made his own but which has mutated seamlessly, without change of substance, from being under the control of the justice department to suddenly being included in a health bill that will apparently be taken forward by the Cabinet Secretary for Health and Wellbeing. One wonders what sin Nicola Sturgeon has committed to be handed this poisoned chalice.

Brian Adam (Scottish National Party, Aberdeen North)

Will the member take an intervention?

Robert Brown (Liberal Democrat, Glasgow)

No. I need to make some progress.

In short, we have an SNP Government that has demoted its justice secretary and stripped him of key functions. The Government has lost its way on one of its few remaining flagship policies. It has delayed the whole process by six months and it still lacks the coherent policies that are needed to tackle Scotland's alcohol challenges. It is a Government without clear direction or the strength of purpose to act in Scotland's interests.

Nevertheless, there is good will in the chamber to come to the aid of a drifting Government on this key issue. Today's debate can help to give a bit of direction and focus to the necessary policies. The motion and the amendments contain elements that we can all agree with. The motion focuses on the parliamentary process, the need to consult various relevant interests and the absolutely necessary requirement to enforce the existing laws more rigorously. The Liberal Democrats have loudly led calls on such matters and have been supported by all parties. However, I take slight issue with the thrust of the rest of the motion. It properly targets binge and underage drinking and the rights of moderate drinkers, but it fails to identify the fact that problem drinking exists as part of a more widespread culture in all age groups in Scotland. I agree with some of the cabinet secretary's comments in that regard. That culture is different from and more deep-seated than the culture in the rest of the United Kingdom or across Europe, and it is at the heart of the issue. Changing our culture requires to be at the heart of our approach.

Earlier, I said that the mix of policies has to be right and that the SNP minority Government is still not fully listening. If, as appears to be the case, its health bill includes its watered-down version of the under-21 ban, its arbitrary social responsibility fee or the bureaucratic minimum pricing proposal, it will be difficult for the bill to obtain parliamentary support. Lots of time and public money could be wasted on developing proposals that might have to be dropped at the end of the day. The sensible way forward is to dump them now and concentrate on things that can obtain parliamentary support, such as the highly innovative idea of the youth commission on alcohol, on which work is proceeding. That work will have enthusiastic Liberal Democrat support. The proposals to limit irresponsible alcohol promotions and the initiative on wine glass sizes can also obtain parliamentary support.

In conclusion, the Liberal Democrats stand ready to work positively with the Government and to contribute our ideas to tackle the challenges of excessive alcohol consumption and problem drinking—which have evil effects on violent crime rates and result in burdens on the national health service—and the central need for cultural change.

The Government has had a false start, but it now has a chance to do things properly. The Conservative motion as amended by the Liberal Democrat amendment would identify the right target and strike the right balance. I hope that our amendment will attract support.

I move amendment S3M-3778.1, to leave out from "any changes" to end and insert:

"tackling Scotland's complex relationship with alcohol will require significant and long-term cultural change, and believes that any proposals for reform of the law should be targeted and evidence-based, introduced on the basis of strong public support and following meaningful consultation with all relevant interests and stakeholders to ensure that measures to address problematic alcohol consumption do not unfairly penalise the majority of individuals who enjoy alcohol responsibly."

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

I hope that we will have a mature debate today and in the coming weeks and months so that we can tackle a serious problem. Indeed, I hope that the debate will be more mature than the relationship that Scots have with alcohol, which is anything but mature. We have a very uneasy—indeed, sometimes a dangerous— relationship with alcohol. At times, we have promoted a hard-drinking culture and people have assessed how much they have enjoyed a night out at the weekend by how little they can remember of it. We cannot be proud of that in Scotland. We must change that culture.

We must acknowledge what the Audit Scotland report that was released this morning identifies. We need greater focus on a number of issues. We must focus on how our spending patterns follow what needs to be done to treat people who have alcohol problems and misuse alcohol and to prevent alcohol problems arising in the first place. The Audit Scotland report contains salutary points about the balance between the money that is spent on treatment and the money that is spent on prevention.

We must recognise that more women are drinking far more than the recommended levels of alcohol and that many of them perhaps do not realise the dangers that they are putting themselves in by consuming what they might think are relatively small amounts. Such women probably do not get drunk or binge drink, but they are nonetheless putting their health at risk. We must also recognise the strain on our accident and emergency units, not only on Friday and Saturday nights and not only because of teenagers who overindulge; others also put strain on those units. Violent crime and other issues go along with problem drinking. The status quo is not an option. We cannot simply say that we are not going to do anything.

I welcome the cabinet secretary's shift of emphasis from considering implementing proposals by regulations that will not be properly scrutinised to having a full and proper debate and consultation. We support the amendment in the name of the cabinet secretary—indeed, I lodged an identical amendment last night—because we want to build consensus, and the way to do that is to involve as many people as possible in the debate. The cabinet secretary must bring together industry representatives, work on a cross-party basis and work with the communities and those who are affected on the front line by having to deal with the problems of alcohol misuse. In building that consensus, I hope that she will recognise that some of her proposals have not found universal favour and that she will be prepared to compromise.

I want to raise a couple of issues about which we need to have a serious debate. Nicola Sturgeon talked about the pocket-money prices of alcohol, the relative cheapness of some alcohol products, and the possible need to introduce minimum pricing. Many people—the family that cannot afford an expensive night out at the pub or in a club, for example—will wonder what risk is posed by a £10 meal deal that includes a bottle of wine, which a minimum pricing regime potentially would outlaw. A unit pricing regime could mean that the price of some premium products that our whisky industry exports would increase while nothing would be done to tackle the problems caused by alcopops and other drinks that are favoured by those who cause mayhem on our streets. Communities that are plagued by antisocial behaviour would wonder whether the balance was right. People who could go online and order drink from south of the border if there was no minimum pricing regime there would, of course, have an advantage over people who go to the corner shop. Those issues are real and serious. That is not to say that we do not have to do something; rather, we must address those real and serious concerns if we want to move on.

Nicola Sturgeon (Scottish National Party, Glasgow Govan)

I agree with much of what Cathy Jamieson says. I want to build consensus and look forward to working with her. However, I ask for her views on two issues. First, does she agree that, although consensus is important, sometimes politicians must lead public opinion and not just follow it? Secondly, does she acknowledge that we have given absolute assurances that the meal deals that she mentions will be excluded from the proposals?

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

It is important that politicians of all parties lead public opinion, which is why it is so important that we try to build consensus. Changing public opinion is not simply about stating a case, refusing to move and refusing to consider what the public have to say. I welcome the cabinet secretary's assurance that so-called meal deals will be excluded. We must have debates on such issues, because surely we should be able to talk to and educate people about drinking responsibly.

Mike Rumbles (Liberal Democrat, West Aberdeenshire and Kincardine)

rose—

Bill Aitken (Conservative, Glasgow)

rose—

Alasdair Morgan (Scottish National Party, South of Scotland)

The member is winding up.

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

I am sorry that I do not have time to take further interventions.

We should not have a situation in which only people on the lowest incomes think that they are being squeezed when others, particularly those who cause the mayhem on our streets, find that they are being let off the hook.

I make a plea once again: the issue is too important for any one political party or individual to think that they have all the right answers. We have not arrived at the right answers yet or at a public or political consensus. If the cabinet secretary is willing to work at building consensus, I will support her. However, that is not to say that we will agree with everything. I hope that she takes what I am saying in the spirit in which it is intended.

Alasdair Morgan (Scottish National Party, South of Scotland)

We now move to the open debate. Speeches should be of around four minutes.

Hugh Henry (Labour, Paisley South)

There is no doubt that we are facing a serious problem in this country. This morning's Audit Scotland report highlights some of the significant issues.

I congratulate the Cabinet Secretary for Justice on the way in which he has raised the temperature in the debate. I understand why he has done that. We had to have a debate and we must confront serious problems. I am also pleased that ministers' emphasis has shifted towards the health problem, to some extent.

Although Bill Aitken is absolutely right that the alcohol-related behaviour of a minority of people in this country causes problems and it is right that we use enforcement and preventive measures with justice-related powers and responsibilities, he did not dwell significantly on the fact that the health of too many people is beginning to suffer because of the hidden consumption of alcohol at home, which is perhaps not so hidden on a night out. We have to realise that many people who do not necessarily pose problems with antisocial behaviour and crime, or who might not regard themselves as problem drinkers, have a growing problem with alcohol. The Cabinet Secretary for Health and Wellbeing documented well some of the significant impacts that such a problem is having.

Bold measures are absolutely necessary—Robert Brown was right to point out the distinction between justice and health, in terms of the language that is used—and Kenny MacAskill was right to raise the debate in the way that he did, but in a Parliament of minorities, it is not enough to talk about agreement and consensus; we need to deliver it. To be frank, there is no party-political advantage to be gained on this matter, and no party-political argument should be advanced to score points over one party at the expense of another; we are in this together. Nicola Sturgeon is right that, as politicians, we should take the lead on the issue. Sometimes there is a question about whether we attempt to lead public opinion, but we cannot do that by trying to ram ideas down the throats of other parties in this Parliament of minorities.

On alcohol policy, above all others, we need a cross-party approach. We should be looking back to some of the historic work that was done by Strathclyde Regional Council, for example, and the officer/member working group reports on which all parties came together to make bold, imaginative and radical suggestions to advance social policy. If either of the cabinet secretaries here today wants to be bold, the bold measure on alcohol policy is to implement a mechanism whereby all parties can come together to work on the issue and come up with some agreement.

The last thing that we need in trying to deal with the alcohol problem is parties trying to score points against one another or fraying at the edges as the argument develops. If we cannot work out together a solution to the problem, the present generation of Scots will suffer and future generations will continue to suffer. We are dealing with too big an issue for us to revert to our party-political dogma and political bunkers. I appeal to the cabinet secretaries to reach out to other parties and I appeal to other parties to approach the problem in the way that it demands—to rise above our political perspectives and come together to work out a solution that will have a lasting effect. It might require radical and bold solutions, but the problem needs that type of approach. For once, can we not do the right thing in this Parliament?

Christine Grahame (Scottish National Party, South of Scotland)

I congratulate Cathy Jamieson and Hugh Henry on their thoughtful speeches, which show Parliament at its best. However, Robert Brown's speech was rather glum. I tried to prise some substance from his speech, which was larded with metaphors, but he kept dancing on the head of a process pin. I think that he has misjudged the mood of the Parliament in this debate.

I turn to Bill Aitken. Moving the debate to being about health has made it an entirely different debate, in which I hope there can be consensus. Mature members of the Health and Sport Committee, rich in life and parliamentary experience and for whom I have high regard, will take on the burden of hearing the evidence.

One problem that we have not addressed is that some of our young Scots suffer from alcohol even though they have had no part in taking it. I am speaking of foetal alcohol syndrome, which was raised with the chief medical officer when he briefed the Health and Sport Committee. It is a great tragedy, not only for the mother but for the staff who deliver a baby who already has alcohol withdrawal symptoms. It is trite but true to say that the healthy mothers who have healthy and responsible pregnancies give children the best start, which continues throughout life. I welcome the survey on foetal alcohol syndrome that is proposed in the framework because it will be a wake-up call to society. Nobody can sit back and say that society should sustain a situation in which babies are born with alcohol withdrawal symptoms.

As members know, when we first discussed the ban on the sale of alcohol to those under 21 I did not agree with my Government, which was pursuing a national policy that I felt was unjust. I very much welcome localisation, whereby the remit is with the local police and licensing boards. I do not think that we will see a geographic purchasing shift from one area to another, but if that happens, the licensing board can adapt to the situation.

I come to the buy-one-get-one-free offers and minimum pricing, which is a thorny issue. The subject was first raised by the Cabinet Secretary for Justice when he was a shadow minister and I was in my great days in the shadow cabinet. I did not agree with him at that time and thought that the policy would penalise those on lower incomes. However, after a great deal of thought I have come round to the view that we must go down the road of minimum pricing, because I do not accept that it is just the young who are purchasing alcohol.

I have great concern for the hidden numbers behind the net curtains of Scotland, who are putting alcohol in their supermarket trolleys on buy-one-get-one-free promotions when they would not normally buy it; because alcohol is within easy reach, they are taking it in the way that they used to drink a cup of tea at night. There are concerns that we will never be able to investigate that situation, and perhaps only the supermarkets can tell us from their stock control the constituency of people who are buying alcohol. It is not just the young and that is where Bill Aitken's targeting argument loses its place; we must look at the whole of society and not just the young, who buy a different type of alcohol.

Mike Rumbles (Liberal Democrat, West Aberdeenshire and Kincardine)

I am interested to hear the views of the convener of the Health and Sport Committee on promotions. The cabinet secretary said that offers such as the Sainsbury's £10 deal would not be affected by the new approach, although we want to affect other deals. How can one possibly differentiate between such deals in legislation?

Christine Grahame (Scottish National Party, South of Scotland)

The cabinet secretary appears to disagree with Mike Rumbles's comment, so I will let him clarify the position in summing up.

In Scotland, we could take the alternative approach of using taxation to deal with the problem, but we are not doing that. Taxation might be a way to tackle it, but pricing is the route that we must take.

John Lamont (Conservative, Roxburgh and Berwickshire)

Will the member give way?

Christine Grahame (Scottish National Party, South of Scotland)

I will conclude, if I may.

We accept many things in life for the greater good—income tax, national insurance and council tax, which finance services that we might not need. In the case of alcohol, society should consider minimum price levels as a burden to bear for the greater physical and mental health of our community and for those babies, who we hope are born without foetal alcohol syndrome.

Richard Baker (Labour, North East Scotland)

All of us realise the toll that alcohol misuse takes on Scottish society, so I welcome the opportunity to debate once more that concern in this chamber. I also welcome the Scottish Government's change of heart on full parliamentary scrutiny of the alcohol framework.

In advance of the publication of the Criminal Justice and Licensing (Scotland) Bill, we called for it to be divided into two separate bills. It is clear that to have debated those major policy proposals only as regulations would have been wholly inadequate, so the fact that they will be decided on in a separate bill is a move forward. However, that is not the only change that must come.

The Conservatives are right to highlight the genuine concerns about enforcement of the current licensing laws. Last year, there were 576 recorded offences of underage drinking and only 88 of them were proceeded against. That is not good enough. There should be a three-strikes-and-you're-out policy for licensees who sell to those who are underage. For ministers to have credibility in introducing their framework, such issues must be addressed properly, particularly as we are discussing further policy initiatives when many of the new provisions in the Licensing (Scotland) Act 2005 are yet to come into force. There must be further changes in the way that the Scottish Government takes forward its proposals on alcohol.

We in the Labour Party genuinely wanted to see more details in the final framework than were in the consultation document, which would allow us to make informed choices about the kind of issue that Mr Rumbles raised. However, additional detail was hard to find, and we still do not know how irresponsible promotions will be defined or how legislation will be framed. It is vital to know that, because there are serious questions of legality.

However, as Hugh Henry said, that does not mean that we should not consider bold measures. Some alcoholic drinks are sold too cheaply, and we are well aware of the scale of the problem of harmful drinking, which is clear from the Audit Scotland report. Nevertheless, whatever the Parliament does has to be legal and workable.

Scottish Labour held a summit to discuss the proposals with a range of organisations but, up until now, the Scottish Government has failed to engage properly with stakeholders on the issue. It is no wonder that the responsibility for this area has been removed from Mr MacAskill and given to health ministers, because the case for the measures to tackle crime and antisocial behaviour has not been made. I refer not only to the flawed proposal to ban 20-year-olds from purchasing at an off-licence—a localised injustice—but to the key proposal on minimum pricing, which will not touch the price of certain alcoholic products that have been identified again and again not only with antisocial behaviour, but with violent crime.

It is right that we have been challenged not simply to criticise and question the Government's policies but to produce our own, which we have done. Our proposals for a mandatory challenge 21 scheme and for alcohol treatment and testing orders have received wide support, but ministers rejected both proposals out of hand for spurious reasons. To do justice to this issue of real concern for Scottish society, the debate must move on and real efforts must be made to reach consensus on policies.

Bill Aitken (Conservative, Glasgow)

I agree with much of what Richard Baker said, but he has skipped over the point about minimum pricing. We need clarification from the Labour Party. Is it in favour of minimum pricing? Does it repudiate the views of Gordon Brown, which I included in the wording of our motion?

Richard Baker (Labour, North East Scotland)

Yes, there needs to be action on pricing, but such action must be explored and considered properly through the bill that we now have before us. It would be wrong to pre-empt that. I welcome the fact that Mr Aitken is reading The Guardian . Who knows where Tory justice policy will end up as a result? Just as Mr Aitken's reading The Guardian is very much out of context, the words of the Prime Minister are very much out of context in Mr Aitken's motion. That is our concern.

If the Scottish Government is prepared to embrace a consensual approach, we can make progress. Attitudes to alcohol in Scotland will not change overnight and laws on their own will not make the difference. We know that whatever we do now will be done after careful consideration and full debate. I hope that the real victory will be a Scotland with a better and more mature relationship with alcohol.

Nigel Don (Scottish National Party, North East Scotland)

As I look at the notes that I have made for my speech, it occurs to me that I do not recall ever seeing a page quite as cluttered—perhaps I need some help from Jim Mather. However, my cluttered notes show just how complicated the debate will be. I am very glad that we will have the debate in the context of a health bill, rather than having a perhaps shorter debate in the Justice Committee. I also think that the Justice Committee is overworked, despite our wonderful convener's attempts to keep us in order, and I am therefore absolutely delighted that some of its work will disappear to the Health and Sport Committee, which I am sure will bring wisdom to it.

We are talking about two very different issues and we will help ourselves if we separate them in the debate. The first issue is the alcohol misuse that is evident on our high streets and in our town and city centres on Friday, Saturday and, increasingly, Sunday nights, when people respond in public to their overdrinking. The police, and all manner of other folk, including our A and E departments, have to deal with that. Most of the folk who have been overdrinking have come out of pubs and clubs and, therefore, the comments that Bill Aitken made about enforcing the licensing laws are entirely to the point. We must ensure that everything possible is done to minimise the difficulties that such behaviour causes.

However, in the meeting of the cross-party group on drug and alcohol misuse, which Mary Scanlon, Richard Baker and I attended yesterday evening, it became clear that the vast majority of the health problem relates to those who are in middle age and who probably do most of their drinking at home. I sense that that is the essence of the health issue. I respectfully suggest to all parties that we must separate that issue from the public order issue. If we allow ourselves to confuse the two, we will not have a sensible debate. My plea is that we distinguish between those issues, so that we recognise which issue we are trying to address and where measures are targeted.

Unlike some others, I congratulate Robert Brown on his performance. I thought that it was a wonderful tribal dance; he managed to dance all the way round the subject without getting anywhere near it. It was a wonderful example and I will look up his speech later to learn the lessons from it.

The wonderful thing about the Liberal Democrat amendment is that it uses the phrase "evidence-based", which I have not found in the motion or the other amendment. I point Robert Brown and his colleagues to the evidence that was presented yesterday evening. As it happens, no one from the Liberal Democrats was at the meeting; I know how busy we all are and I do not mean that as a criticism. A lot of the evidence was produced by Petra Meier at the University of Sheffield last year.

We have to look at the academic evidence on which of the various interventions will have an influence on drinking and its consequences. I will persuade the Health and Sport Committee to look at that evidence, although I do not think that it will require much persuading. I do not think that it will be terribly difficult to work out what we should be doing.

There are a few other issues to pick up. Bill Aitken referred quite properly to policing issues around St Neots. I suggest that those who are not familiar with East Anglia look at the map. I had to check this, but I found that St Neots is 10 miles from anywhere. I have nothing against St Neots, but I think that it is relatively straightforward to police somewhere that is 10 miles from anywhere on not-very-good roads. I question the lessons that our larger cities can learn from the St Neots experience, although I recognise entirely that it might be relevant in the Borders and other remoter communities.

Frank McAveety (Labour, Glasgow Shettleston)

I thank members for bringing forward the debate. Rather belatedly, we can have an honest discussion on a fundamental issue, about which I do not think that there is any disagreement. We must try to deal with alcohol much more sensibly and effectively.

However, I am concerned that some of the language that predated the debate was alarmist. The policies that members of the Government were advocating before being held to account today—I hope that they will be held to account after today—demonised the taking of alcohol, whereas the real issue is the culture of binge drinking at home and the exhibition of binge drinking in public places throughout the towns and cities of Scotland.

I have a philosophical concern. I acknowledge that the debate we are having is the beginning of a fundamental debate. However, I am concerned that some fundamental issues are not being addressed properly. I worry when I hear the Cabinet Secretary for Health and Wellbeing say in response to some speeches that our responsibility is to show leadership and to lead public opinion, rather than follow it. Tackling alcohol is substantially different from tackling smoking and to try to equate the two shows a level of sophistry that is beyond belief, given the debate that we should have.

Nigel Don mentioned tackling the issue of isolated drinkers. I come from a family in which the males had substantial problems with alcohol misuse. The reality of my experience growing up was that if the price of alcohol was increased, people would find ways of getting round that to access the alcohol; they would find alternative drinks or a different way of acquiring the alcohol in the first place. The debate has been about absolutes, when the real experience of those who have family experience of alcohol abuse is quite different.

We have been here before. Although the debate in Scotland is not equivalent to the prohibition debate in the United States of America following the first world war, the language is similar. The anti-saloon laws of 1916 in the USA were an attempt

"to improve health, solve social problems and to reduce crime"

Herbert Hoover called prohibition the noble experiment. The legislation was debated in the House of Representatives on a single day. More than 16 hours were given over to a debate on one of the most important and well-known decisions of the House of Representatives in the 20th century. During the debate, one member said that, in tackling alcohol misuse, the Government

"might as well have been trying to dry up the Atlantic with a post-office blotter."

The reality of the debate in Scotland is similar: how do we take a measured view on tackling alcohol misuse, which is an issue that people across the country know about only too well.

I welcome the Government's change of approach on the 18 to 21s, but I am not convinced by its proposals, which might lead to a postcode lottery on access to alcohol off-sales. I question whether its proposal is the most appropriate way of doing things.

I turn to two important issues that have not been raised in the debate thus far, the first of which is our contradictory relationship with alcohol. Everyone, including cabinet ministers, needs to reconcile themselves to that. Indeed, our national rugby team was sponsored by an alcohol product and the Scottish rugby union, two major football clubs and our biggest music festival are all sponsored by alcohol products. The debate with the industry on that sponsorship and how to tackle alcohol abuse is legitimate. Demonising alcohol serves only to jeopardise the private sector sponsorship that is necessary for such sport and events to happen. None of them happens because of public sector investment; they happen as a result of private sector commitment. We need to address the issue.

Secondly, the point about alcohol being cheaper than bottled water is sometimes repeated. Perhaps the question should be why bottled water is so expensive.

We need to have a much more measured debate on the issues. I hope that that is what we will hear today in the summing up, and over the weeks and months ahead in the Parliament.

Mike Rumbles (Liberal Democrat, West Aberdeenshire and Kincardine)

The Liberal Democrats welcome the SNP Government's decision to bring forward a bill on its controversial alcohol proposals. On this matter, it has dropped its take-it-or-leave-it attitude to lawmaking in Scotland.

We are glad that the Government has seen sense. It has realised that it will not get away with trying to bulldoze its controversial proposals through Parliament by way of regulations that Opposition MSPs cannot amend. Four of the Government's six proposals—minimum pricing per unit of alcohol, alcohol promotions, limiting the use of marketing materials, and regulating the size of wine glasses—were put forward in such a way that they could not be amended by Opposition MSPs. Only two measures—the sale of alcohol to under-21s and the social responsibility fee—were to be examined in a parliamentary bill. That is despite the fact that the Government lost a parliamentary vote on the proposal to raise the purchase age to 21—yet here we are again with the same kind of proposal.

Unfortunately, the Government's change of heart on process came about neither as a result of reasoned argument, compromise and co-operation nor—to use the First Minister's fine words—because it is a "listening Government" but because the Liberal Democrats, the Labour Party and the Conservatives made it clear that we would simply vote down the undemocratic method that it was intent on using to push through the measures. Let us have no more nonsense from this SNP Government about it being a "listening Government"; let us instead have a reality check.

The SNP Government is very slow to learn. Just yesterday, it came to light that it was using another parliamentary tactic to try to stop Opposition MSPs lodging amendments to the Education (Additional Support for Learning) (Scotland) Bill.

Nicola Sturgeon (Scottish National Party, Glasgow Govan)

Will the member give way?

Mike Rumbles (Liberal Democrat, West Aberdeenshire and Kincardine)

Wait a minute.

In order to stop that Government tactic and misuse, I had to come to the chamber yesterday afternoon and, with the support of my Labour and Conservative colleagues, request a special meeting of the Parliamentary Bureau. This is a minority Government with a majority ego. It wants to stifle proper debate and prevent Opposition MSPs from lodging legitimate amendments to its legislation. What a way to treat Scotland's national Parliament.

Nicola Sturgeon (Scottish National Party, Glasgow Govan)

Whatever the member thinks about our motivation, we have conceded that there should be a bill, so surely that should bring an end to the argument on process. Will Mike Rumbles do what Robert Brown signally failed to do and tell us where the Liberal Democrats stand on the substance?

Mike Rumbles (Liberal Democrat, West Aberdeenshire and Kincardine)

It is clear that the Government wants to forget about the mistakes that it has made so far with its proposals on alcohol. It does not want us to talk about using the Scottish Parliament properly and having a proper debate about all the issues. It wants to forget about all of that. The Government has seen sense over the way in which it will put its proposals on alcohol to Parliament. I had hoped that ministers had learned their lesson, but yesterday's shenanigans over Opposition amendments made it clear that it has learned nothing.

Although Bill Aitken did not use this phrase, I took from his speech that he opposes the position that the Government knows best. I rather agree with him.

The Cabinet Secretary for Health and Wellbeing falsely compared the Government's alcohol proposals with the smoking legislation. How wrong could she be? The smoking legislation was radical and it was accepted across the chamber. It was not made into the sort of partisan issue that the SNP has made its proposals on alcohol.

In a very good speech, Cathy Jamieson highlighted concerns over minimum pricing and the missing of Government targets. She questioned why, although some promotions need to be stopped, the Scottish whisky industry should be damaged in the process. That was a good point.

When I intervened on Christine Grahame about the outlawing of alcohol promotions, she could not answer the question that had been put earlier to the Cabinet Secretary for Health and Wellbeing. I think that this is important. How can the cabinet secretary say that a £10 meal deal from Sainsbury's that includes a bottle of wine will not be outlawed when other offers will? What about unintended consequences?

The Government says that it will take over six months to work up the detail of its bill proposals—well, what a surprise! Has the Government not done that work? Did it not bother to do the detailed work for a piece of legislation that it wanted the Parliament to rubber-stamp and to either take or leave? It is a disgrace. We cannot operate a Scottish Parliament in that way. We cannot have a Government coming to the Parliament with such ill-thought-out plans and ideas. It is not sufficient for the Scottish Government to ask the Parliament to legislate on such important issues when the Government does not have a clue about the detail.

Richard Simpson (Labour, Mid Scotland and Fife)

Unlike my Liberal Democrat colleagues, I welcome the Government's acceptance that the issue should be moved to the health portfolio and that there should be proper debate on it. The issue is too serious to do anything else.

I am wearing four hats in the debate: as shadow public health spokesperson, as a member of the Health and Sport Committee—as Christine Grahame said, the committee will have an important role to play in all of this—as the chairman of the cross-party group on drug and alcohol misuse, and as a former psychiatrist who dealt with the alcohol problems with which we are confronted.

As Frank McAveety said, the problem with debating alcohol as a justice issue is that it runs the risk of demonising drink. The difference between drink and smoking is that smoking is totally pernicious—there is no benefit—whereas drinking in moderation is a health benefit. We run a grave risk of demonising drink and of being perceived by the public to be doing that, and some of the debate on justice aspects has contributed to that.

In the sort of thoughtful speech that we have come to expect from Nigel Don, he said that we have to separate out the issues. As other members rightly said, the central problem in the debate is excessive drinking by a very substantial minority and not the public safety issue that we have all seemed to concentrate on and which has taken up much of the debate in the press.

There has been a massive rise in cirrhosis among the over-40s. Also, 11 per cent of emergency attendances are associated with alcohol, and they relate mainly to the over-40s. Indeed, the most significant growth is among over-60s. We need to tackle the group of people who have developed an inappropriate cultural approach to alcohol over a long period of time.

We also need to look at the growth of alcohol consumption among women, which has been even greater than the growth of consumption among men.

What we do in Scotland has to be the subject of debate in the Scottish Parliament. Why? Because the problem is hugely greater in Scotland than in England. Over the past few years, there has been a marked rise in alcohol consumption in England, but England has reached only the European Union average for cirrhosis whereas the figure for Scotland is 2.3 times that average, and rising. We need to find Scottish solutions to what is essentially a Scottish problem.

Labour will not act in haste. We did not do so on the proposal to raise the off-sales purchase age to 21—we took a few weeks to examine the evidence before saying that, as a public health measure, it was a non-starter. We will consider proposals carefully and take the opportunity that has been afforded by the Government's change of heart to enter into a debate. That is reflected in the fact that, for the first time in this session, we produced an amendment that was identical to one lodged by the Government.

Bill Aitken (Conservative, Glasgow)

rose—

Richard Simpson (Labour, Mid Scotland and Fife)

I am afraid that I do not have time to take an intervention.

Last night, we looked at the issue of minimum pricing and heard a presentation by a consultant psychiatrist who favours the measure. A representative of the Scotch Whisky Association told us that there might be problems with what he called commoditisation—at some point, I will look up the word to find out what in heaven's name he meant by that. We need to balance the industry's concerns with those of clinicians, who definitely favour minimum pricing. However, there must be no doubt that the consumption of alcohol is price sensitive; all the papers, including those from Sheffield and the Australian medical colleges, are clear on that fact.

We need to have a debate but, as Cathy Jamieson said, we must ensure that we are not seen to punish impoverished moderate drinkers. We need to achieve a balance. When we see that alcopops and Buckfast are not affected by minimum pricing, we realise that we have a job of work to do. Undoubtedly, some of the problems are not price related but cultural.

Thirty-nine of the 150 sections of the Licensing (Scotland) Act 2005, which was Labour's attempt to move us forward on the issue, have not yet been implemented. Those include sections relating to drunkenness and to the consideration by licensing boards of overprovision of licensed premises. It is important not only that we implement all sections of the 2005 act but that we enforce them. So far, enforcement of the legislation has been tragically weak—it needs to be reinforced.

Labour is up for this debate and is prepared to try to reach agreement on issues. However, it must be a careful and mature debate.

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

We welcome the debate. There is a great deal of consensus around the chamber on the problem that we face. Two strands—the problem and the process—have run through the debate. I thank Richard Simpson for his comments on the process; the Liberal Democrats should have taken those points on board. It would be churlish of me not to say that the procedures that were suggested for many issues were introduced by Tavish Scott and George Lyon. However, at the end of the day, we want to resolve differences over process so that we can concentrate on tackling the problem. We will do so through a health bill. Hugh Henry and Cathy Jamieson acknowledged the huge damage that alcohol misuse is causing to our society. We hope that we can draw a line under debates on process and start addressing the problem that so many speakers have highlighted.

Bill Aitken spoke about a road-to-Damascus conversion. Perhaps the biggest such change in the Conservative party is its recognition that there is such a thing as society. Speaker after speaker recognised that alcohol misuse is damaging our communities. Clearly, it is not simply a criminal justice matter, as the effects of alcohol misuse are not limited to problems with behaviour. Frankly, it is killing far too many of our communities and damaging individual citizens. We must move on.

Issues to be considered include the action that must be taken, enforcement and education. More can and should be done on enforcement. Richard Simpson referred to the 2005 act, the provisions of which are being rolled out. There will be a big bang in September, when many of the changes will kick in. At that point, licensing boards will have more power to take appropriate action. We are surprised that some people wish to restrict licensing boards to a policy of three strikes and you're out. We want to ensure that boards can adopt a policy of one strike and you're out; if there has been a flagrant breach, licensees should not be given the opportunity of further culpability. That is why we ask members to support the action that is being taken to give boards the power to adopt such a policy.

Enforcing provisions against underage drinking is problematic for the police. Reference has been made to pocket-money prices. If we impose fines on our children—as some seem to be suggesting—those fines will be taken out of their pocket money, because some of the youngsters whom the police are taking in as drunk and incapable are not 16 or 17-year-old laddies who are in work or apprenticeships, but 12 or 14-year-old young girls who, if they are lucky enough to have pocket money, are blowing it on alcopops. We accept that enforcement is necessary and will work with members to ensure that appropriate action is taken. The Government will ensure that the police, procurators fiscal and licensing boards are joined up and communicate with one another, and that licensing boards are aware of who is offending.

Richard Simpson (Labour, Mid Scotland and Fife)

One of the things that disappoint me most is the Government's failure to follow through on the work of the national licensing forum, which provided essential support to local boards, and to monitor the extent to which support for boards varies. The Government said that the Convention of Scottish Local Authorities could do that job.

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

We have met COSLA and Alcohol Focus Scotland and have made clear that we think that such a forum is appropriate. However, it would be better for it to come from them than from us because, as today's debate has shown, there may be issues on which they disagree with the Government. We will support COSLA and Alcohol Focus Scotland fully in setting up a forum that is able to deal with Government, but it should come from them, because they are distinctive stakeholders with particular interests in the area.

We have addressed the issue of process; the Liberal Democrats must address the issue of what they will do about the problem and, as Christine Grahame indicated, the substance. We have a rather perverse situation, given that the Liberal Democrats are a federal party that recognises that devolution should allow one part of the United Kingdom to go in a particular direction to deal with particular problems. As Richard Simpson and Cathy Jamieson pointed out, the problem of alcohol abuse is greater in Scotland. The irony and shame for the Liberal Democrats is that they do not want to act in the part of the United Kingdom where the problem is significantly greater than it is elsewhere. I compare that position with the courageous steps that have been taken by Christopher Huhne and Nick Clegg.

Mike Rumbles (Liberal Democrat, West Aberdeenshire and Kincardine)

It is clear that the Government does not have a clue about the detail of the legislation that it intends to introduce. Surely the most important point is that it should provide us with that detail, so that we can examine it properly. The Government has not done that.

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

It is rather tragic that, whereas Nick Clegg can make proposals that this Government supports fully, in the part of the United Kingdom where the Liberal Democrats wish to make a difference and where the problem is significantly greater than it is elsewhere, they take no action.

We recognise that issues will have to be worked through and that we must work with the trade. The Scottish Licensed Trade Association is squarely behind the Government on many issues. We will work with the appropriate stakeholders to make clear that the suggestion that the meal deals and offers will be affected is spurious.

We must take action. We recognise the problems that Scotland faces and accept that there is not one quick-fire bullet that will solve them. It is about enforcement, education and making changes. Three years after the smoking ban, we can change the situation. However, we need legislative change to ensure that we deliver cultural change.

John Lamont (Conservative, Roxburgh and Berwickshire)

As we have heard from a number of speakers in today's debate, excessive alcohol consumption is a major issue for Scotland. We all agree on that point and acknowledge the health concerns that the Cabinet Secretary for Health and Wellbeing set out in her speech. Research has revealed that Scotland is eighth in the world for alcohol consumption per head of population. One in three men and one in four women in Scotland exceed recommended daily alcohol limits.

As our motion states, we welcome the Scottish Government's U-turn on railroading its alcohol proposals through the Parliament by regulation, which was an attempt to sneak through a deeply unpopular policy in the most undemocratic manner, by avoiding proper parliamentary scrutiny. However, we remain concerned that the Government's proposals penalise responsible retailers and consumers and fail to address overconsumption.

I will address a couple of issues that were raised in the debate, beginning with the minimum price proposal. The Scottish Government's plans for a minimum price for alcoholic drinks will adversely affect many of the communities and local economies that we represent. What is more, the proposal sends out confusing messages and fundamentally fails to target the problem drinks that contribute so significantly to Scotland's alcohol problem. Retailers have suggested that the cost of problem drinks such as alcopops and high-strength spirits, which are often used as shooters, would not be affected by a minimum price.

J D Wetherspoon was recently criticised for selling a pint for £1, but if minimum pricing were applied to the on-sales trade, that pint could be sold at no profit for as little as 70p. The minimum price plan would primarily increase large volume cider prices; most single bottles or cans would remain unaffected. The pricing plan would have the biggest impact on wine, which is a drink that I—and many members, I am sure—occasionally enjoy responsibly. Minimum pricing would raise the price of 19 per cent of the wine and 15 per cent of the spirits that are currently sold in Scotland.

Hugh Henry (Labour, Paisley South)

Does the member agree that we should be wary of a minimum pricing strategy that would put money into retailers' pockets but not into funding additional nurses, doctors or police officers? Does he agree that we should consider a United Kingdom-wide strategy that involves a more effective and equitable taxation system?

John Lamont (Conservative, Roxburgh and Berwickshire)

I agree. The way forward is to tax problem drinks. Nearly half the young men who were charged with an offence in 2007 revealed that they had been drinking Buckfast immediately prior to committing the offence. Conservatives think that the Scottish Government should be working with Westminster to put forward proposals to address alcohol abuse by taxing problem drinks such as alcopops, strong beers and ciders and Buckfast, while reducing the duty on low-strength beers and ciders, to maintain cost neutrality.

Blanket minimum pricing would penalise responsible drinkers and could have unintended consequences. I am concerned that the Scottish Government's proposals would create a booze-trip culture in the south of Scotland, which could hit traders in my constituency in the Borders. A trend could be started whereby responsible drinkers travelled across the border to places such as Berwick and Wooler to purchase cheaper alcohol, which would have a clear effect on traders in the Borders. I wanted to make that point during Christine Grahame's speech. Has the Scottish Government thought about the issue and would it allocate additional resources so that it could be policed?

All members know that opinion polls are important bedtime reading for Alex Salmond and the SNP Government. What do opinion polls say about the Government's plans? When 10,000 people were asked what they thought of the Government's proposals for a minimum price for alcohol, 61 per cent were opposed to the idea. When they were asked what they thought of the proposal to ban three-for-two and other multibuy promotions, 67 per cent opposed the proposal. What does the Government think about the overwhelming public opinion against its proposals?

There is no amendment from the Labour Party and, from what we have heard, it seems likely that Labour members will vote for the SNP amendment. It is important to record that, if that happens, Labour members will be voting to remove from the motion words that were used by Labour Prime Minister Gordon Brown. Perhaps someone from the Labour Party will tell us whether Labour members intend to vote with the SNP because the motion expresses Gordon Brown's view in his own words.

Richard Simpson (Labour, Mid Scotland and Fife)

We are in a devolved Parliament. In Scotland, the level of alcoholic cirrhosis is more than twice the EU level and we have a much more rapidly developing problem. Along with the SNP Government, we will seek a Scottish solution to our problems, and I hope that there will be a consensus in that regard.

John Lamont (Conservative, Roxburgh and Berwickshire)

I wonder how out of touch Gordon Brown is. He is a Scottish member of Parliament, so I would have thought that he would be fully aware of those points and would be more than happy to back Scottish Labour's proposals, although we have yet to hear what they are.

Rather than pursue ineffective and unpopular proposals, we should be enforcing existing laws on licensing and the sale of alcohol, as Bill Aitken said. Police and local traders and other stakeholders should be working much more closely in community-based alcohol partnerships and we should learn from how that model is working in Cambridgeshire, London and many other parts of England. Work is needed in our communities to help to tackle alcohol abuse through education and counselling. We should not punish people who drink responsibly; we should work towards legislation that will address the problem of alcohol abuse in our communities. Conservative proposals to target problem drinks through increased taxation should be pursued. We need responsible and reasoned legislation, which will properly address alcohol abuse in Scotland. I hope that that can be achieved through further debate.

Question Time — Scottish Executive — General Questions

Stuart McMillan (Scottish National Party, West of Scotland)

To ask the Scottish Government what assistance it is providing to people looking for employment in Scotland in light of recent figures showing that an average of 10 people apply for each jobcentre vacancy. (S3O-6434)

Fiona Hyslop (Scottish National Party, Lothians)

Although employment policy is a reserved matter, the Scottish Government is doing everything in its power to help people to look for employment in Scotland. Since January, we have invested considerable effort in strengthening our national redundancy service: partnership action for continuing employment, or PACE. For example, Skills Development Scotland dedicated 80 staff to work with Jobcentre Plus staff, some of whom will be on site in jobcentres. That is unique in the United Kingdom and represents a step towards the wider integration of employment and skills services, so that people get the most effective help to get back into work.

Stuart McMillan (Scottish National Party, West of Scotland)

The community of Inverclyde, where I live, has suffered vast job losses in the shipbuilding and heavy engineering sectors and, more recently, in the electronics sector. Now that the UK economy is in recession, Inverclyde and every other part of Scotland face even more job losses as a result of the UK Government's shambolic handling of the economy.

Does the cabinet secretary agree that the confusing messages from the UK Government and the Bank of England might well be exacerbating the unemployment statistics in Inverclyde, which is 14th in the list of UK parliamentary constituencies in Scotland, ranked by unemployment rate?

Fiona Hyslop (Scottish National Party, Lothians)

I very much appreciate the situation in Inverclyde. I have experience of the area and I have visited Port Glasgow jobcentre, where one of the integrated employment and skills pilots is taking place. It is essential that we all pull together to seek resolution.

It is right to identify the responsibility of the UK Government in relation to the recession. There are issues about what would benefit areas in Scotland where there are shipbuilding and construction skills. In such areas, investment in capital infrastructure might be better than some of the support that is currently being provided.

Cathie Craigie (Labour, Cumbernauld and Kilsyth)

The Scottish Government is not doing everything in its power to support employment in Scotland. Thousands of construction workers are sitting at home because of the Government's failure to plan and deliver capital projects, such as new schools and houses. Will the Government move to deliver on a capital works programme and at least get us back to where we were in 2007, when investment of £1.3 billion was in the pipeline—as opposed to investment of only £300 million now?

Fiona Hyslop (Scottish National Party, Lothians)

I hate to contradict Cathie Craigie, but she should have listened to Tony McNulty, the Minister for Employment, Welfare Reform and London at Westminster, when he agreed that the Scottish Government is doing everything in its power to support employment.

The member quoted a figure of £1.3 billion for the previous Executive's investment in schools. This Government is investing £2 billion in schools—

Cathie Craigie (Labour, Cumbernauld and Kilsyth)

Where is it? Where are the schools?

Alex Fergusson (None, Galloway and Upper Nithsdale)

Order.

Fiona Hyslop (Scottish National Party, Lothians)

Some 250 schools are currently under construction.

On a positive note, I ask the Opposition to acknowledge that this Government brought forward £100 million of capital investment in housing to support the construction industry. Only on Monday, the Scottish Further and Higher Education Funding Council outlined which colleges will receive investment, to ensure that the £20 million that has been brought forward for construction can be invested now to provide for construction workers. I will take no lessons from the Labour Party on the matter.

Margo MacDonald (Independent, Lothians)

To ask the Scottish Executive whether it will instigate national testing in reading, writing and maths for 10-year-olds, to ensure that underachieving pupils have the opportunity to catch up before starting secondary school. (S3O-6367)

Keith Brown (Scottish National Party, Ochil)

No. Good literacy and numeracy skills need to be developed from the early years. Curriculum for excellence is our means of ensuring that there is rigorous, on-going assessment of literacy and numeracy skills in primary and early secondary stages, based on clear, nationally agreed benchmarks.

Margo MacDonald (Independent, Lothians)

I thank the new minister and I welcome him to his post. He will be hearing more from me if I get more answers like that.

It is acknowledged that the basic skills of reading, writing and arithmetic have been falling over the years. Scotland is falling down the league table of achievement in those skills. It is not fair to wait until some children leave school to think about testing them, as the Cabinet Secretary for Education and Lifelong Learning has suggested. Will the minister turn back the clock and allow primary teachers to decide whether their pupils can read, write and count before they go on to secondary school? Will he ensure that we come up with a means of enabling pupils to catch up without embarrassing them?

Keith Brown (Scottish National Party, Ochil)

That is exactly the approach that we are taking, but it will be done through assessment and not through testing, which is not supported by anybody in the teaching profession that I have been able to find. In fact, Greg Dempster, the general secretary of the Association of Headteachers and Deputes in Scotland said that

"proposals ... to test P7 pupils in literacy and numeracy need to be re-thought ... An 'exam' at this stage would offer nothing other than a baseline for secondary schools or, at worst, an opportunity for the secondary sector to point the finger of blame at primary schools ... It would do nothing to address literacy and numeracy problems, as these are best tackled as early in schooling as possible."

That is what we intend to achieve. The curriculum for excellence includes assessment, so teachers will have an understanding of the literacy and numeracy skills of their pupils. In our view, that is the major change going through Scottish schools from August this year to August next year and it is the best way to proceed.

Elizabeth Smith (Conservative, Mid Scotland and Fife)

In light of that answer, will the new framework for assessment include a specific recommendation on the type of literacy and numeracy testing that will be introduced in Scottish primary schools by the end of primary 7?

Keith Brown (Scottish National Party, Ochil)

Yes, it will include that. The member will understand that the exact process of assessment is being discussed. However, it is also true that the Cabinet Secretary for Education and Lifelong Learning will announce next week the outcomes and experiences under the curriculum for excellence. That is the next milestone in the process towards achieving an agreed assessment process. For the reasons that I have outlined, we are very much against the idea of testing P7 pupils. There is no support among teacher trade unions or teachers more generally for the testing of children of that age. There will be assessment, but only on the basis that teachers agree to it.

Christine Grahame (Scottish National Party, South of Scotland)

On the question of basic skills and literacy, the minister will be aware that, in its inquiry on pathways into sport, the Health and Sport Committee has uncovered a lack of reporting on physical literacy and physical skills in school reports by Her Majesty's Inspectorate of Education and, indeed, a similar lack of reporting by schools in pupil report cards. Does the minister share the committee's concerns about that?

Keith Brown (Scottish National Party, Ochil)

Having spent, along with Shona Robison, an hour and a half answering questions from the committee on that and related subjects, I am well aware of the committee's concerns. I am well aware, too, of the committee's interest in ensuring that physical literacy is developed in schools. As I have said previously, it will be for schools to assess an individual pupil's progress in ways and at times that are appropriate for the young person's needs. Through the health and wellbeing strand of the curriculum for excellence, assessment must take account of the breadth and purpose of the wide range of learning that children and young people experience in that curriculum area. I am confident that, through curriculum for excellence, we will address some of the concerns that the committee raised.

Johann Lamont (Labour, Glasgow Pollok)

Does the minister recognise that there is some concern that the strategy on primary school class sizes may be at the expense of specialised learning support, which is particularly important for youngsters who underachieve at that stage? Can he reassure me that, no matter what happens on class sizes, he will sustain the level of specialist learning support in our primary schools to ensure that children's support needs are picked up quickly and that individualised support can be given to them?

Keith Brown (Scottish National Party, Ochil)

I can only say that there are no plans in the class size strategy to reduce the current provision for specialist learning. It is our view that, through curriculum for excellence, we will improve the ability to deliver those services to pupils who are in need of them. I do not therefore think that the member's concerns are well founded. I am certainly happy to discuss the matter further with her, if she has a concern.

David Whitton (Labour, Strathkelvin and Bearsden)

To ask the Scottish Executive when it will announce a strategy on creating green jobs. (S3O-6414)

John Swinney (Scottish National Party, North Tayside)

In February, we announced 10 pledges that form the basis of our approach to ensuring that Scotland's energy sector is an aid to economic recovery and creates new jobs. We estimate that at least 16,000 new jobs could be created in the renewable energy sector by 2020. Our renewables action plan, which is to be published this summer, will map out the contribution of each renewables sub-sector towards meeting our 2020 energy targets and delivering economic benefit.

David Whitton (Labour, Strathkelvin and Bearsden)

As the cabinet secretary has said, the Government has set a target of 50 per cent of electricity to be generated by renewables by 2020. He mentioned 16,000 jobs, but is that the only estimate that he has of jobs to be created? I would have thought that he could have been a bit more ambitious, given the target that he has set. What steps is he taking to encourage modern apprenticeships, for example, in areas that will provide the jobs for the future?

John Swinney (Scottish National Party, North Tayside)

First, the 16,000 jobs figure is an estimate, not a target. The Government produced that estimate on the basis of looking at the position within the wider estimates of United Kingdom employment and consider it to be reasonable. I can assure Mr Whitton that it is by no means the sum of our ambitions. We are seeing a range of different developments and the approval of different consents for new renewable energy schemes. The Government is very confident that new employment will be created in the renewable energy sector. I am sure that we will hear more about that in due course.

Mr Whitton asked about apprenticeships. We must ensure that we identify the apprenticeship places that are relevant for future employment. The Cabinet Secretary for Education and Lifelong learning has therefore taken the key approach of guaranteeing that we will have the closest dialogue with business and different sectors of the economy to ensure that our education institutions and training providers educate people in the right skills for the jobs of the future, which will be in the renewable energy sector.

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

On Tuesday, the Economy, Energy and Tourism Committee visited Caithness to study the potential of tidal energy in the Pentland Firth. Constructing subsea turbines would offer a large number of high-quality green jobs. Making that happen is crucial as Dounreay decommissions and skills become available. Will the cabinet secretary look closely at how we can make that development happen? Turbine fabrication could take place onshore in Caithness and in the Nigg yard. Will the cabinet secretary look at both areas with a view to establishing what financial resources are necessary and what impediments must be overcome, such as the unfortunate stalemate at Nigg?

John Swinney (Scottish National Party, North Tayside)

The Government will do everything that it can to try to bring the relevant parties together to ensure that the enormous prospects for wave and tidal energy in the Pentland Firth can be realised. We are greatly encouraged by the opportunities that now exist as a consequence of the decisions announced by the Crown Estate. We have made it clear that we are determined to create a strong renewable energy industry. We look forward to further announcements on that in due course. Certainly, if particular obstacles stand in the way of onshore developments to support offshore activity in the Pentland Firth, the Government will be happy to do all that it can to resolve such issues. Jamie Stone knows that I will respond promptly to any requests for assistance in that respect.

Duncan McNeil (Labour, Greenock and Inverclyde)

To ask the Scottish Government what it is doing to protect children who live with a parent with a drug addiction. (S3O-6402)

Adam Ingram (Scottish National Party, South of Scotland)

The needs of children who are affected by parental substance misuse is a key priority for the Government. Within a year of coming into office we issued "The Road to Recovery: A New Approach to Tackling Scotland's Drug Problem", which sets out the Government's national drugs strategy and includes a chapter specifically on protecting children. It has been followed up by a project board on children affected by parental substance misuse, which involves the Scottish Government, local authorities and the voluntary sector, that meets on a six-week cycle. Among a range of actions, we have increased funding to health boards for drug treatment by 13.5 per cent for 2009-10 and established a learning partnership under the getting it right for every child programme with Angus Council and partner agencies to explore further ways to identify, protect and support better children whose parents misuse drugs or alcohol and ensure that adult services working with such parents make their children's interests a priority.

Duncan McNeil (Labour, Greenock and Inverclyde)

I am more interested in action than in publications and meetings. In a written question in 2007, I asked the minister how many children were living with a parent with a drug addiction. He estimated the number to be between 10,000 and 20,000. When asked the same question two weeks ago by my colleague Karen Whitefield, he gave the same unsatisfactory answer. What has he been doing over the past two years to identify and meet the needs of those children? On a day when Audit Scotland confirms that billions are being spent on adults with an addiction, is it not time that he got a share of that budget to tackle the real issues for the real victims of abuse?

Adam Ingram (Scottish National Party, South of Scotland)

What children need from us are services that meet their individual needs and risks, not number crunching. The statistics are a means to an end. Duncan McNeil's views on this issue are well known and he is welcome to them. While we share his concerns for children who are affected by parental substance misuse, we do not agree with his prescription for action.

The Government trusts the front-line professionals who engage daily with these vulnerable children and families. Our job is to provide the support and back-up that they need to do their jobs effectively. The getting it right for every child programme encapsulates the approach that we believe in. Its key aims are to ensure that every child is safe and has their needs met holistically, and that family relationships are strengthened.

Nicol Stephen (Liberal Democrat, Aberdeen South)

To ask the Scottish Executive what progress has been made on refinancing the Aberdeen 3Rs school project to allow building work on the affected schools to restart. (S3O-6454)

Keith Brown (Scottish National Party, Ochil)

Landsbanki hf has commenced a refinancing of the project on behalf of the NYOP Education (Aberdeen) Ltd consortium. It would be inappropriate for the Scottish Government to comment on matters that are the subject of commercial negotiations.

Nicol Stephen (Liberal Democrat, Aberdeen South)

If the current situation is what the minister calls accelerating major capital projects, his foot might be on the pedal but his tank is full of empty rhetoric. The First Minister likes to take credit for new schools that are built by local councils. Will the Government now take some responsibility when projects stall? This is a crucial time for that major project in Aberdeen. We were promised that building would be under way again by the end of March but, so far, as the minister explained, the project has not even been refinanced. The Treasury has announced a scheme in England and Wales to support private finance initiative and public-private partnership projects when finance is no longer available from the private sector. Will the minister confirm that similar support will be provided in Scotland and will be available to underwrite the restart of building new schools in Aberdeen where there are currently empty building sites?

Keith Brown (Scottish National Party, Ochil)

The Treasury scheme to which the member refers has not yet been implemented fully, but we are considering its implications and the benefits that it might have for Scotland. On the member's point about delays to projects, everyone is well aware that the project in Aberdeen is delayed because of the collapse of the Icelandic banking system. I point out to the member that schools that he approved in my area in 2002 are still not finished or opened, seven years on, and are massively over budget, so perhaps he should look to himself when he asks such questions.

Kenneth Gibson (Scottish National Party, Cunninghame North)

To ask the Scottish Government, in developing the details of the town centre regeneration fund, whether it will include plans to inform local communities about how they can apply for funding. (S3O-6423)

Alex Neil (Scottish National Party, Central Scotland)

The full details of the town centre regeneration fund will be announced shortly. Every effort will be made to ensure that the information is widely disseminated.

Kenneth Gibson (Scottish National Party, Cunninghame North)

The minister will be aware that, from Whiting Bay to Wigtown and from Largs to Lerwick, the Tories have been encouraging people in every community in Scotland, big or small, to nominate their community for an award from the fund via a Tory party website. Does he agree that that is irresponsibly raising false expectations of what the scheme can deliver and that it will have no bearing on how funds can be distributed?

Alex Neil (Scottish National Party, Central Scotland)

The decision-making process on awards under the town centre regeneration fund will be made by ministers in consultation with other stakeholders, which does not include the Conservative party.

Rhona Brankin (Labour, Midlothian)

To ask the Scottish Executive what meetings are planned between ministers and leaders of local authorities to discuss education. (S3O-6379)

Fiona Hyslop (Scottish National Party, Lothians)

The Minister for Children and Early Years will visit Tarbolton primary school nursery in South Ayrshire on 31 March, during which the leader of South Ayrshire Council will be present. I plan to meet Councillor Steven Purcell from Glasgow City Council soon to discuss education matters. In addition, plans are being developed for the Minister for Schools and Skills to visit a number of local authorities. Those are examples of our frequent meetings with leaders of councils, other councillors, senior officials from local authorities, representatives of the Convention of Scottish Local Authorities and many others to drive forward our shared commitment to improve educational outcomes for all children and young people.

Rhona Brankin (Labour, Midlothian)

On 12 March, the cabinet secretary told Parliament that it is up to Glasgow City Council whether it spends its £196 million of capital funding on school buildings. In fact, £115 million of that funding is ring fenced for projects including the M74 extension and the White Cart Water flood prevention scheme. Will the cabinet secretary apologise to Glasgow City Council and the Parliament for her misleading remarks? Will she tell us when the Scottish Government plans to stop hiding behind spin and bluster and put in place adequate funding for school building, so that pupils and teachers in Glasgow and elsewhere can benefit from fit-for-purpose learning and teaching environments?

Fiona Hyslop (Scottish National Party, Lothians)

The Government is investing £2 billion in schools, and 250 schools are under construction. I would be delighted to meet Steven Purcell to discuss some of the concerns that many parents have about schooling in Glasgow. Glasgow City Council is undergoing a process of school closures, but that is a matter for the council, and it would be inappropriate for me, as minister, to comment on that publicly at this moment.

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-1574)

Alex Salmond (Scottish National Party, Gordon)

Later today, I will have meetings to take forward the Government's programme. Earlier this morning, I wrote to Mr Gray following my commitment to look into the case that he raised during First Minister's question time last week. Given the clear interest of the Parliament in the matter, I will place a copy of that letter in the Scottish Parliament information centre.

Shortly after question time, I will travel to Kintyre to announce the latest investment in renewables in Scotland—a truly transformational announcement for the Mull of Kintyre. It is hugely significant for Scotland, and the Parliament will no doubt hear more about it during the economy debate this afternoon.

Iain Gray (Labour, East Lothian)

I did get a letter from the First Minister a few minutes ago, and I am happy to have a look at it, but I make no apology for standing up for a young apprentice last week. I am delighted that, on Friday, he heard that he would be able to complete his apprenticeship. So is his dad—he thanked me at the weekend. There are dozens of people in the position that Lewis Doig was in last week, with an uncertain future, and we need the apprenticeship guarantee to be made good for them all.

Today, I want to ask about another of the First Minister's promises. The SNP manifesto said:

"We will maintain teacher numbers in the face of falling school rolls to cut class sizes".

Why has the First Minister not done that?

Alex Salmond (Scottish National Party, Gordon)

It is not a question of whether members are able to stand up for their constituents—I am sure that every member of the Scottish Parliament tries to do that. It is simply a question of getting the facts right, as the correspondence will indicate that Iain Gray so palpably failed to do.

The Scottish Government has delivered the best pupil teacher ratio in history, for not just this year but the second successive year. That is important in itself but, at 13.1:1, the pupil teacher ratio in Scotland is significantly better than the ratio in England where it is 17:1, than the ratio in Wales where it is 18:1, and than the ratio in Northern Ireland where it is 17:1. Perhaps Iain Gray should have a word with his colleagues south of the border and try to get them to emulate the Scottish experience on pupil teacher ratios.

Iain Gray (Labour, East Lothian)

This is not a question about England, Wales or Northern Ireland; it is a question about a promise that was made in Scotland to the parents and pupils of Scotland. The man who promised to maintain teacher numbers is right here in the chamber, and he is the one who is breaking that promise. Will he tell us what he is going to do to put that right?

Alex Salmond (Scottish National Party, Gordon)

It is interesting to note from the statistics that many councils in Scotland have managed to maintain teacher numbers; indeed, some have managed to increase them. I welcome that, as I think that the concordat has enthusiastic support across local government in Scotland.

Andy Kerr (Labour, East Kilbride)

Oh no.

Alex Salmond (Scottish National Party, Gordon)

I know that Andy Kerr did his best to destroy the concordat at the outset and that he has tried to instigate problems for it, but the concordat has delivered for the people of Scotland across a range of issues.

The Cabinet Secretary for Education and Lifelong Learning will pursue with the Convention of Scottish Local Authorities—at its invitation—and with individual councils the question why not every council in Scotland has managed to achieve the teacher numbers that we would all wish. On that basis, and given Rhona Brankin's remarks of just a few minutes ago, we might wish to reflect on the fact that 20 per cent—one fifth—of the fall in teacher numbers in Scotland seemed to come from the city of Glasgow.

Iain Gray (Labour, East Lothian)

If the First Minister is not blaming Westminster, he is blaming councils. However, this is not about a promise made by council leaders in Glasgow, Aberdeen, Renfrewshire or anywhere else; the man who promised to maintain teacher numbers is Alex Salmond, and Alex Salmond is breaking that promise. When will he put it right?

Alex Salmond (Scottish National Party, Gordon)

As Iain Gray will remember, in the concordat the idea was to make year-on-year progress towards lower class sizes in Scotland—and, of course, we now have the best class sizes in Scotland that have ever been recorded.

If Iain Gray wants to argue that I would wish that some councils in Scotland made faster progress towards that commitment, then the answer is yes. I would like to hear an explanation of why, when the education convener of Glasgow City Council says that there is record education spending in the city, the spending does not translate into maintaining the number of teachers in the great city of Glasgow.

Iain Gray (Labour, East Lothian)

We are not making progress on the promise. In four years, Labour increased teacher numbers by 2,000; in half that time, the SNP has wiped out half of that progress. We are going backwards.

I do not know about the concordat, but the First Minister's school report is certainly a disaster. Teacher numbers: failed. Class sizes: failed. School building programme: failed. Physical education in schools: failed. Free school meals: failed. Nursery school teachers: failed. The buck stops on the SNP front bench. Who will take the blame—the First Minister Alex Salmond or his hapless cabinet secretary Fiona Hyslop?

Alex Salmond (Scottish National Party, Gordon)

I would not get on to the school building programme if I was Iain Gray; that was his mistake two weeks ago, before his mistake about his constituency case last week.

Within the past few days, we have heard about the full extent of local government finance that the concordat makes possible. We have also heard the comparison, which Iain Gray does not want to make, with England and Wales. This coming year, local government finance in Scotland is increasing by 5.5 per cent.

Andy Kerr (Labour, East Kilbride)

Standstill.

Alex Salmond (Scottish National Party, Gordon)

In England, the figure is 4.2 per cent.

Alex Fergusson (None, Galloway and Upper Nithsdale)

Order, Mr Kerr.

Alex Salmond (Scottish National Party, Gordon)

Andy Kerr says, "Standstill." If 5.5 per cent is a standstill in Scotland, what is 4.2 per cent in England? And the figure is Wales is 3 per cent.

One of the great things about the concordat is that, because we work in agreement, it has allowed record council funding in Scotland, it has delivered a freeze in council tax, and it has delivered the small business bonus. Those things are important to people in Scotland. The biggest threat to local government finance, and to every other public service in Scotland, is the £500 million of cuts that are coming down the tunnel from the Labour Government in London.

Annabel Goldie (Conservative, West of Scotland)

To ask the First Minister when he will next meet the Prime Minister. (S3F-1575)

Alex Salmond (Scottish National Party, Gordon)

I have no plans to meet the Prime Minister in the near future.

Annabel Goldie (Conservative, West of Scotland)

Last year, as one of the conditions for supporting the Scottish Government budget, the Scottish Conservatives called for a national audit report on drug abuse. The report published today is chilling. Five people die every day in Scotland from drink and drug abuse, and the abuse has a wider impact, costing Scotland an estimated £5 billion a year. That is a horrific verdict on eight wasted years under the previous Executive.

Alarmingly, the £5 billion figure is only a guesstimate. The audit report makes clear that actual Scottish figures for drug abuse were expected last May, and the Auditor General for Scotland's office confirmed to my office this morning that the Scottish Government commissioned that information. Nearly a year later, why has the First Minister not published the figures? What is being kept hidden?

Alex Salmond (Scottish National Party, Gordon)

I will investigate the matter and get the figures that Annabel Goldie wants as soon as possible—just as we, for the first time, have investigated the scale of the alcohol abuse problem in Scotland and have published the figures.

On the burden of Annabel Goldie's question, I agree whole-heartedly. We were delighted to commission the Audit Scotland report, which has identified many of the issues that she and I and others in the Parliament felt were wrong about the direction of drugs policy.

There are three issues at stake. One is to get the strategy right, and we have made a substantial step forward on drugs in moving towards the road to recovery and putting the emphasis on recovery—that also applies to alcohol abuse.

The second issue is to get the balance right and to understand, as the Auditor General's report indicates, that the alcohol problem in Scotland is even greater than our huge drug problem. Those problems together cost £5 billion in financial terms, but in terms of human misery they cost a great deal more. It is about getting the balance of funding right, and I am sure that Annabel Goldie will acknowledge that that is exactly what we have done, with a 230 per cent increase in alcohol funding and a 14 per cent increase in drug abuse funding during the comprehensive spending review period.

The third issue, which is of huge significance and which the Auditor General's report identifies as a factor that is perhaps greater than any other, is that the delivery of and the mechanisms to deliver the policies that we all want in Scotland must be correct, must be audited and must translate into helping real people in real families.

Annabel Goldie (Conservative, West of Scotland)

I hope that the missing report will be published, as that information is urgently needed.

Prevention should be at the heart of any strategy, but the report states that only 6 per cent of spending goes into that area. Will the First Minister commit to increasing that? Will he commit to simplifying the dog's breakfast of funding and treatment structures? Finally, with two thirds of prisoners testing positive for drugs on admission to jail, will the First Minister commit to drugs-free prisons? [Interruption.]

Alex Salmond (Scottish National Party, Gordon)

I heard "no more money" in a sedentary intervention. In fact, Mr Rumbles—and as Ms Goldie well knows—the drugs budget is increasing by 14 per cent during the CSR period, and the alcohol budget for preventing and addressing abuse is increasing by 236 per cent. Substantial resources are going in.

The point on which I agree with Annabel Goldie—and on which the Auditor General's report greatly reinforces concerns—regards delivery and the impact of the investment that is being made. Annabel Goldie has written to me to suggest a number of things with which I am happy to agree. That includes her idea of a summit, albeit with one proviso: the summit should not be another discussion about the concepts because we have moved beyond that stage. We have a new direction for drugs policy, and the alcohol and drug abuse budget has been rebalanced. The summit must focus on delivery and the auditing of delivery, and it should ensure that the good intentions and the huge budget that go into those areas are matched by real help on the ground to real families and people.

Tavish Scott (Liberal Democrat, Shetland Islands)

To ask the First Minister what issues will be discussed at the next meeting of the Cabinet. (S3F-1576)

Alex Salmond (Scottish National Party, Gordon)

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

Tavish Scott (Liberal Democrat, Shetland Islands)

Following the December fisheries council, the Scottish National Party fisheries minister said that it was a "huge relief"; it was "blazing a trail"; there had been "breakthroughs"; he was "delighted" by it; and fishermen "would sleep easier".

I spoke this morning to skipper Michael Henderson who was sailing back to Peterhead. He says that the fishermen get "no sleep" in the storms because there is nowhere for them to shelter—he has been forced by the Government's regulations to fish 240 miles beyond Rockall, out in the Atlantic. Men will lose their lives if that goes on, skipper Henderson told me this morning. Scottish fishermen face "bankruptcy" because of the deal that the Government signed in December.

Those are not my words but those of Scottish fishing leaders. When will the First Minister act to change the fishing regulations that his Government is imposing on the industry?

Alex Salmond (Scottish National Party, Gordon)

Tavish Scott is wrong in his analysis of the situation. The deal that was signed in December introduced flexibility into the common fisheries policy, and its application will stand the fishing industry in good stead—that point is agreed across the industry's representative organisations. As Tavish Scott should know and as any fishing MP is well aware, the biggest pressure on the fleet at present is the substantial decline in langoustine prices. That is not to do with what is happening in the home market but with what is happening in markets elsewhere. It is putting substantial financial pressure on the industry, as I am—and every fishing MP is—acutely aware.

Tavish Scott (Liberal Democrat, Shetland Islands)

It is interesting to hear that the First Minister is an MP now: that will be news to people in Banff and Buchan and in the House of Commons, given that he missed the fisheries debate there last December.

The First Minister's answer was utterly in denial of what is happening in the fishing industry in Scotland today. To ignore the fact that men are being injured on boats while fishing in the Atlantic around Rockall shows that he is in denial about this very serious issue for the industry. Those men are fishing out there not from a desire to fish those dangerous waters in winter but because of the implementation of the European deal by the SNP Government.

The fisheries minister is being told today that scores of fishermen could be out of a job. The industry is saying that this is the deepest economic crisis for 15 years, and half the Shetland fishing fleet—including new boats—face a 20 per cent cut in fishing days. There is complete chaos over the nets to be used. A skipper from Macduff said last night—[Interruption.] This is a serious issue, despite the groans about it from the SNP members.

A skipper from Macduff said last night that the Scottish Government's fishing regulations mean that he must tie up his boat for five weeks then fish for three. Fishermen are angry—how can they make a living out of that? Ministers can give the fishing industry no answers other than platitudes and rhetoric. They give no detail where detail is needed. Will the First Minister tell his Government to sort out this mess and to work out the details? The fishing regulations that are crippling boats can change from the end of April—

Alex Fergusson (None, Galloway and Upper Nithsdale)

Come to a conclusion, please.

Tavish Scott (Liberal Democrat, Shetland Islands)

Will the First Minister make that change happen to help the fishing industry in Scotland?

Alex Salmond (Scottish National Party, Gordon)

This Government has always stood up for, and always will stand up for, the fishing industry of Scotland. At the previous two fisheries councils, faced with extraordinary difficulties, by general acknowledgement we have managed to gain valuable flexibility in allowing fishing effort to be placed in Scotland.

Let me say to Tavish Scott that, unlike him, I would never be in a Government from which I had to resign because it would not represent the fishing industry of Scotland.

Alex Fergusson (None, Galloway and Upper Nithsdale)

I will take a constituency question from Angela Constance.

Angela Constance (Scottish National Party, Livingston)

The last remaining branch of Lord Roberts Workshops, which is in my constituency, faces closure this June. The workshop provides sheltered employment for disabled ex-servicemen and women, many of whom suffer from post-traumatic stress disorder. Given the First Minister's stated support for veterans and ex-servicemen and women, will he ensure that the Scottish Government actively explores all the options to save that service? Will he consider accepting an invitation to visit the workshop in Livingston?

Alex Salmond (Scottish National Party, Gordon)

Extensive dialogue between the management of Lord Roberts Workshops and Scottish Government officials has culminated in an offer of a £10,000 Scottish Government grant to meet the cost of a comprehensive business review and evaluation of the workshop. That offer was accepted only today. In addition, the Scottish Government has pointed Lord Roberts Workshops to the assistance that is available from the enterprise fund, and we understand that the organisation is exploring that option. Furthermore, we have recommended that contact is made with the local authority and the local enterprise company, and we hope that Lord Roberts Workshops will pursue that proposal. By all means, if a ministerial visit would help the matter, I will make that arrangement.

Alex Fergusson (None, Galloway and Upper Nithsdale)

I will take a further question from Jamie McGrigor.

Jamie McGrigor (Conservative, Highlands and Islands)

In the light of last Saturday's dreadful tragedy on Loch Awe, where two men from Glasgow lost their lives and two more are sadly still missing, and considering the high number of deaths by drowning in Loch Awe in recent years, will the First Minister or his relevant representatives respond to the wishes of local people by meeting me and other politicians, local Royal National Lifeboat Institution representatives, community councillors and members of other relevant bodies around Loch Awe to create a framework to improve safety and aid rescue operations on Scotland's longest freshwater loch?

Alex Salmond (Scottish National Party, Gordon)

I thank Jamie McGrigor for giving notice of his question.

On behalf of the whole Parliament, I express my deepest condolences to the families of the four victims William Carty, Craig Currie, Steven Carty and Thomas Douglas. As the constituency member knows, the incident is now part of an on-going police investigation and potentially other investigations. Therefore, it would be inappropriate to comment in detail or to draw conclusions from the information that is available, but I would be happy to arrange for the Minister for Community Safety, Fergus Ewing, to meet Mr McGrigor and the organisations that he identified.

Aileen Campbell (Scottish National Party, South of Scotland)

To ask the First Minister what steps the Scottish Government is taking to support children and young people who may feel depressed or suicidal. (S3F-1586)

Alex Salmond (Scottish National Party, Gordon)

The Scottish Government is committed to supporting children and young people who have mental health problems or are suicidal, and we will continue to build on the excellent work that has been undertaken to date in Scotland.

We are currently working with national health service boards and other partners to deliver the specific objectives set for children and young people's mental health. That includes continuing investment in programmes to reduce stigma, to improve the capacity and capability of services to respond to those in distress, and to achieve faster access to those vital services.

Aileen Campbell (Scottish National Party, South of Scotland)

The First Minister will be aware of the recent report from ChildLine Scotland that indicates that Scotland has had a sevenfold increase, in five years, of calls from children who are reporting suicidal feelings. Indeed, the Scottish rise is steeper than that of the United Kingdom.

Does the First Minister share my shock and concern about those disturbing and upsetting figures and my concern that, while those who call ChildLine receive expert help and advice, there may be many more distressed children and young people who do not make the call and cannot be reached? Will the First Minister confirm that the Government will consider how best it can make information available to young people, parents and, particularly, carers, on spotting the signs of depression and potential suicide, which is one of ChildLine's key recommendations?

Alex Salmond (Scottish National Party, Gordon)

I certainly agree that we must work together to promote the wellbeing of children and young people and to address their needs as early as possible. We must build on their strengths and promote resilience using existing networks and support whenever possible. When necessary, we must provide additional help, as identified by the member, that is appropriate, proportionate and timely, whether that is through schools or the health service, through supporting parents or, indeed, through expert services such as ChildLine.

Karen Whitefield (Labour, Airdrie and Shotts)

I very much welcome the commitment on the part of the First Minister and his Government to tackling the issue. Access to specialist psychological services is vital for those children. Is the First Minister aware that the child and adolescent mental health service in Lanarkshire believes that it requires £1.8 million to improve staffing levels to a level comparable with other CAMH services in Scotland? Will the First Minister agree to meet me to discuss how, together, we can lift that much-needed service from the bottom of the table in the Scottish Government's recently commissioned survey by ISD Scotland?

Alex Salmond (Scottish National Party, Gordon)

I hear what the constituency member says. I would be delighted to arrange a meeting with the Deputy First Minister to pursue the points that she has identified.

Christine Grahame (Scottish National Party, South of Scotland)

I advise the First Minister that the Health and Sport Committee this week launched an inquiry into mental health services for children and adolescents. In our evidence, we found that 33,000 children had contacted ChildLine this year. I ask that his Government gives weighty consideration to our report when it is finally published, as I think that it is the first such inquiry on the subject by any committee during the lifetime of the Scottish Parliament.

Alex Salmond (Scottish National Party, Gordon)

I agree with the convener of the Health and Sport Committee. The mental health of our children and young people is a key priority, and we will certainly listen carefully to what the committee has to say.

Hugh O'Donnell (Liberal Democrat, Central Scotland)

In the light of the First Minister's comments, will he explain how blocking amendments to the Education (Additional Support for Learning) (Scotland) Bill and reducing the availability of training opportunities through the getting ready for work scheme for some of the most vulnerable young people in Scotland will contribute positively to the outcomes that he seems to support?

Alex Salmond (Scottish National Party, Gordon)

As has generally been agreed, the bill is designed to correct the deficiencies in the previous legislation. As the member well knows, if financial provisions or provisions that have financial implications are introduced into bills, they have to be considered differently. A bill that is identified to correct previous deficiencies should not in itself have financial implications.

Paul Martin (Labour, Glasgow Springburn)

To ask the First Minister what steps the Scottish Government is taking to tackle gang-related violence. (S3F-1578)

Alex Salmond (Scottish National Party, Gordon)

Last December, we announced a £1.6 million package to support the community initiative to reduce violence. As the member knows, it is a project that is being delivered in the east end of Glasgow. The groundbreaking project is delivering a mix of tough enforcement and intensive services to turn around 700 young lives and make those communities safer. We are also supporting a Scotland-wide initiative that is delivering a range of programmes to more than 500 young men, in an attempt to challenge their negative attitudes and change their behaviour.

All of that work is being supported by visible and sustained police enforcement, which is being co-ordinated by the national violence reduction unit through its anti-violence campaign, the current phase of which is targeting gang violence. That is aided by the 441 extra police officers that have been delivered throughout Scotland by this Government since May 2007—record police numbers, which enable the police to help in initiatives to reduce violence.

Paul Martin (Labour, Glasgow Springburn)

The First Minister will agree that gang-related violence is unacceptable and blights far too many communities throughout Scotland. I seek assurances from him that, in tackling such unacceptable behaviour, the Government will stop making excuses for the tiny minority of people who commit antisocial behaviour and start to represent the majority of decent men, women and children in our communities by ensuring that it delivers the legal measures in the Antisocial Behaviour etc (Scotland) Act 2004, which was introduced by the previous Executive. Will the Scottish Government enforce those measures properly instead of diluting them, as is set out in "Promoting Positive Outcomes: Working Together to Prevent Antisocial Behaviour in Scotland"?

Alex Salmond (Scottish National Party, Gordon)

I am sure that Paul Martin welcomes the initiatives that I have outlined. The Government never makes excuses for those who perpetrate violence. That is why there are record numbers of police officers in Scotland and why it seems that, over this term, we will exceed the target of 1,000 more police officers on the streets of Scotland than we would have had if the Labour Party had stayed in government.

Robert Brown (Liberal Democrat, Glasgow)

The First Minister rightly touched on the projects in the east end of Glasgow, not least operation reclaim, which operates in Petershill. That project uses football as an incentive and a motivator to break down gang divisions and to foster positive attitudes. Has he seen the figures that suggest that there has been a 35 per cent cut in crime in the surrounding area as a consequence of such initiatives? I acknowledge the investment that has already been made, but is it a model that the Government will support and replicate more widely, both in Glasgow and throughout Scotland?

Alex Salmond (Scottish National Party, Gordon)

Yes, I agree with Robert Brown. He is entirely correct that the initial figures show a dramatic result from the investment that is being made in those initiatives. In my first answer to Paul Martin, I mentioned the Scotland-wide initiative that is targeting 500 young men in an attempt to challenge negative attitudes and behaviour. However, we do not claim that gang violence is specific to Glasgow and Strathclyde; it is a problem in many parts of Scotland. The success of the initiatives that have been taken suggests that they should be applied on an all-Scotland basis.

Ross Finnie (Liberal Democrat, West of Scotland)

To ask the First Minister what forecast the Scottish Government has made of how many junior doctors will be working more than 48 hours per week from August 2009. (S3F-1594)

Alex Salmond (Scottish National Party, Gordon)

On the basis of the figures that have been supplied by national health service boards, around 57 per cent of junior doctors are already working an average of 48 hours or less a week. That is up from the figure of 51 per cent that was recorded six months ago. We expect that, as NHS boards continue their efforts to comply with the working time regulations, the figure will continue to rise and will approach full compliance by 1 August. In order to get a more accurate projection of the number of junior doctors who may still be working more than 48 hours a week by August, the Scottish Government is issuing guidance to all NHS boards to require them to provide details of current and projected compliance levels.

As Ross Finnie knows, overall compliance with the working time regulations is a reserved matter, but the Scottish Government is doing what it can to help individual NHS boards to achieve compliance by their junior doctors by disseminating information on good practice, issuing guidance, holding seminars and providing practical advice including advice on the redesigning of junior doctor rotas.

Ross Finnie (Liberal Democrat, West of Scotland)

The First Minister and his Cabinet colleagues are always swift to take the credit for health boards' meeting waiting time targets, so I am sure that he would not want to duck any responsibility in relation to the working time directive. He tells us that he hopes that the target of full compliance will be met by August but, in replies that were given to me by the Cabinet Secretary for Health and Wellbeing on 9 March, she not only confirmed the figure of 50 per cent to which the First Minister has referred but talked about the fact that almost 100 per cent of junior doctors are meeting the new deal target of 56 hours a week. On that basis, there is a shortfall of 16,000 hours in meeting the working time directive, which equates to 330 junior doctors working 48 hours a week. Where will the First Minister find those 330 junior doctors by August?

Alex Salmond (Scottish National Party, Gordon)

The figures are moving in the right direction all the time. The latest figure is 57 per cent, not the 51 per cent of six months ago. What the United Kingdom Government does or does not do in these matters is of some importance, not least because it has just announced its intention to apply to the European Commission for a derogation from the working time directive.

The figures in Scotland are moving substantially in the right direction, and I would have expected Ross Finnie to find it in his heart to welcome that progress as well as, rightly, focusing attention on what remains to be done.

Question Time — Scottish Executive — Rural Affairs and Environment

John Scott (Conservative, Ayr)

To ask the Scottish Executive, in light of the recently published December 2008 survey of agriculture, what action it will take to halt the decline of agricultural production. (S3O-6366)

Richard Lochhead (Scottish National Party, Moray)

The statistics illustrate a long-term global trend and put into perspective the challenges that face one of Scotland's most important industries. The Scottish Government provides agriculture with more than £500 million annually in direct support. In response to suggestions from stakeholders, we are considering other ways of helping, such as seeking to identify ways of strengthening the link between those payments and active farming.

John Scott (Conservative, Ayr)

The minister will be aware of increasing concern that the critical mass of the livestock sector is reducing to such low levels as to threaten the future of our abattoir sector, our haulage industry and other ancillary suppliers and processors. Our dairy industry in Ayrshire and our pig industry in the north-east have been particularly affected. Will he suggest how those industries should plan for the future? Is he considering, through the Scotland rural development programme, ways of helping to secure the future of those sectors and other parts of the food-producing industry?

Richard Lochhead (Scottish National Party, Moray)

The member makes an important point. Part of the debate is about critical mass. The jobs concerned are those not just of farmers in fields and livestock farmers, but of many others in related sectors, such as haulage and abattoirs. It is important to bear that in mind when we discuss the future of those sectors.

My message to livestock farmers in Scotland is that they must take decisions in line with the commercial environment in which they operate, first and foremost. We as a Government—and, I am sure, the member, his party and other members—believe that the livestock sector in Scotland needs a vibrant long-term future, especially given the need for food security, which is an issue not just for this country, but globally. Our farmers are of course at the heart of food production in Scotland.

We will continue to look for ways to address a trend that is global but which has an impact on Scotland. We will consider what we in Scotland can do at least—I hope—to stabilise livestock numbers. As the trend has been long term in recent years, there is no overnight solution. We want to work with other parties, our stakeholders and wider rural communities to ensure the best possible future for the livestock sector.

Alasdair Allan (Scottish National Party, Western Isles)

As the minister knows, productivity in the most marginal part of Scotland's agricultural sector—crofting—faces an enormous practical challenge from European proposals for the electronic tagging of sheep. What is the Scottish Government doing to ensure that those proposals do not make crofting impractical altogether in the view of many crofters?