Subject debate: Improving Scotland's Health

The Deputy Presiding Officer (Murray Tosh): Good morning. The first item of business is a debate on rising to the challenge of improving Scotland's health. The debate will be concluded without any questions being put.

09:30

... ... ...

16:35

Stewart Stevenson (Banff and Buchan) (SNP): We have had two announcements from the minister today, and an announcement that there will be an announcement next week. Is that enough to justify an all-day debate without a motion? Well, yes, it certainly allowed a wide-ranging debate, which is excellent. It has enabled many points that would not have come out in any other way to be brought to the chamber. Have we, as members, learned how to use this form of debate to best effect? I suspect not. We still have to learn. The format is still on trial as far as I am concerned.

Across the chamber and across the parties, members have made many points of interest, some of which were local and some of which were of national concern. The challenge for the Executive is to show that it will respond to this form of debate. Of course, the Executive will not respond positively to everything that has been said, because it does not agree with everything, although there is much agreement round the chamber. I hope that ministers will reflect on those remarks, because, if they fail to respond, not just the Executive will suffer public opprobrium as a result of this debate format, but the chamber as a whole.

John Swinburne: On that point, I have sat here for 4 hours and 20 minutes but have had no opportunity to represent senior citizens in today's debate, which is shameful. It would not take rocket science for the Presiding Officer to curtail everyone's time slightly to give us all a chance to participate.

The Deputy Presiding Officer: Order. That is not a point for Mr Stevenson, but a point for me, which should have been raised as a point of order. This chair will not dispute in the chamber the choice of speakers or the allocation of time. I make the observation that we reduced the time for speakers in the afternoon. Seven members asked to speak and were not called—I forgot about Mr Sheridan earlier. No matter how we had handled the debate, there is no way that we could have shoehorned in an extra seven members.

Stewart Stevenson: I am sympathetic to John Swinburne's attempt to bring the issues associated with older people to the chamber. Members around the chamber have raised such issues. I am reaching a point where, not too long from now, I might be a pensioner as well.

We discussed money as part of today's debate. We keep hearing that there is more of it in the health service, and I believe that—money is going from the Executive's balance sheet and into the health service—but all of us have experienced meetings with health service professionals who say, "Well, that's fine, but where's the money? What's it doing? It doesn't seem to be reaching me."

At First Minister's question time today, my leader John Swinney raised the private finance initiative, which is only one of the clues to what is actually happening. The costs of PFI are considerable. There are many models for bringing the private sector to bear on public projects. The French in Napoleonic times had la concession, which was used to build the canals. The private sector built them, and the public sector committed to buy them after they were built. There are different models around the world.

The real point is that few schools are built by council brickies and few hospitals are built by NHS staff. The private sector is in there. It is not about who does the building of things, but about the diversion of NHS money into the banks' coffers and profits. My mortgage interest rate is about 4 per cent per annum. PFI projects borrow at around 8 per cent, with mezzanine finance at rates up to 14 per cent. Why is that so? My old boss, who was a bank chief executive from the local area, told me that with the SNP's trust model he would lend to trusts in the public sector at three sixteenths of a per cent over bank base rate, provided that the Government provided a guarantee. The cost of that guarantee would be approximately 5 per cent of the total project fund, which is more or less the difference between the first year's interest payment in the trust model and the interest payment in the PFI model. That is where some money is going. The Executive must open its mind on that issue.

I will deal with the operation of the NHS, because the debate is not all about money; it is really about patients. Some people appear to have suggested that NHS staff do not care about patients and do not put patients first. I do not meet such staff; I think that all NHS staff believe that they put patients first and want every opportunity to do so.

The public bring two subjects in particular—the health service and schools—to MSPs, because we have personal experience of them. I have a number of communications on school issues, but the public's view is increasingly that the health service is in poor health, like many people throughout Scotland.

We will not improve the health of people unless we improve the quality of our health service. The Minister for Health and Community Care courageously accepted that, in cancer services at the Beatson, we had to do more, and he addressed himself to doing so. I thank him for doing that, which is exactly what we want. That is some progress, and I say conditionally that we are moving in the right direction. However, it might be too little, too late. Consultants are resigning from the health service in areas that have particular pressures and shortages. When that happens, we are on a downward slope, because it becomes difficult to recruit more people.

I will focus on dentistry, about which one or two members talked and in which I have a special interest. Manchester has one dentist for approximately every 1,000 people and Edinburgh has one for every 2,000, but rural north-east Scotland and the Highlands and Islands have one dentist for approximately every 4,000. That shortage means that lists for NHS patients are all but closed in the dental service. In some towns, even private dentists cannot take new patients.

What does the Government know about the dental service? Does an NHS dental service exist at all?

Christine May: Will the member give way?

Stewart Stevenson: I do not have time; I have another eight pages of notes for my speech.

I have asked a series of parliamentary questions about the dental service. In question S2W-2355, I asked how much NHS dentists earn. The Government does not know. In question S2W-626, I asked how long people must wait to join a dentist's list. The Government does not know. In question S2W-625, I asked how many people are on a waiting list to join a dentist's list. The Government does not know. In question S2W-2356, I asked how many foreign dentists are working temporarily in the NHS. The Government does not know. In question S2W-2352, I asked how far patients must travel for NHS dental treatment. The Government does not know. The most astonishing answer is to question S2W-2353, which asked how many dentists are working in the NHS. The Government does not know.

The golden hello scheme was designed to bring more dentists into the health service and pays up to £10,000 for three years in some circumstances. The scheme has been such a success that six golden hellos have been approved. One golden hello has been given in Forth Valley NHS Board's area, two have been given in Lothian NHS Board's area, and the initiative has also been used in the Greater Glasgow NHS Board and Dumfries and Galloway NHS Board areas. However, no golden hellos have been received in Grampian NHS Board's area or Highland NHS Board's area, where the greatest pressure is felt. Do national dental services exist?

That situation affects not only dentistry. Scotland has 50 GP vacancies. Despite health board efforts and additional funding, will our remoter communities find themselves in a similar position in which we do not have the people to do the job and services cannot be delivered?

Ministers should think about social conditions. People who are captured by tobacco or other drug addictions will continue to suffer at the hands of those who exploit their compelling needs. Alcohol abusers will continue to suffer and to inflict suffering on others.

The Parliament has the power to empower patients and practitioners and to provide funds that can liberate our health service from the dead hand of overcontrol. Indeed, that is the consistent message that my colleagues and I constantly receive.

Although we can get better on the money that has been provided, we can get more for that money if we moved a little bit away from PFI. However, we need a successful economy in a successful country before we can solve the deep-seated problems that underlie the health service and so much else in Scotland. That means being a normal, independent country.

16:45

S2M-310 Aquaculture

The Presiding Officer (Mr George Reid): The next item of business is a debate on motion S2M-310, in the name of Allan Wilson, on "A Strategic Framework for Scottish Aquaculture".

14:36

... ... ...

16:23

Stewart Stevenson (Banff and Buchan) (SNP): In 1968, when I was a student, I spent a very happy summer working with the Tay Salmon Fisheries Board. It was already apparent then that wild salmon stocks were in severe decline—I have to say that that was not due to my inefficiency as a water bailiff; the decline was a long-term one. Therefore, it is no surprise that fish farming has had to replace wild stocks. In 150 years, we have come from a position where people who worked on farms on the estates pleaded to be fed salmon no more than three times a week. Of course, salmon is once again popularly available.

I will focus on what the Executive's strategic framework does not contain because, after all, it is perfectly possible to give a broad welcome to what it includes. I will focus in particular on the sustainability or otherwise of the feed stocks that are essential to the future of fin fish in our aquaculture industry.

The feed sustainability study that is dealt with in paragraphs 3.59 and 3.60 of the strategy document is almost a footnote and, as far as I can see, is not referred to under the objectives in appendix 3. I hope that the minister will be able to tell us that he is making progress on it.

Feed sustainability is an important area. I note that Papua New Guinea attempted to set up a fish-farming industry and failed because of problems with the food stock—there was not enough omega oil in the trout that they were breeding. It is important that we get feed sustainability right to keep our aquaculture industry on track.

I note that, in the ministerial working group on aquaculture, no one appears to represent that particular interest. I hope that those who were present have taken on board—

Allan Wilson: There was indeed a representative from the foodstuffs industry. I understand that a sea feeds report has been published and that its recommendations have been picked up by the Scottish aquaculture research forum.

Stewart Stevenson: I am grateful to the minister for that. It is not clear from the list of representatives who that person is, but I accept that that is the case and I welcome that.

Nonetheless, feed sustainability is an issue that goes beyond the aquaculture industry into the white-fish industry, which is certainly not represented directly on the ministerial working group. The main source of raw material for feed stock for the aquaculture industry is industrial fishing, not just in the North sea, but around the world—off the coast of South America, off the west coast of Africa and in the far east. The fact that the Danish industry takes 1.5 million tonnes of food that haddock, cod and other essential stocks in the North sea would otherwise have eaten is a matter of concern to the white-fish industry. I would like a greater emphasis on the industrial fishery as it affects not only aquaculture but the future of our white-fish industry in science and in the politics of Europe.

We have talked about Europe and we have heard references to Norway and the lifting of the controls over the import into the EU of Norwegian salmon. It is a great paradox that, although Norway is outside the EU, it has more influence on the decision-making process affecting our fishing industry than does Scotland, which is in the EU. It is time the minister told us how he plans to remedy the imbalance of power and delivery that is obvious to many of us.

The Crown Estate has been mentioned. Jamie Stone mentioned Tain and James VI. It is great that the benefit of shellfish farming is felt by the local community. We heard from George Lyon that the Crown Estate takes £15 million out of our industry each year. Some 1.3 per cent of that returns to Scotland. If only Tain's experience were replicated throughout Scotland.

The quality of the Scottish product is vital. We know that considerable work must be done to keep up that quality. Today, I lodged a motion on sourcing local products and I hope that there will be an opportunity to have a member's debate on that subject in the coming months. In the first two hours after I lodged the motion, 15 people signed it.

I ask the minister whether the Scottish Executive discriminates in favour of Scottish salmon in its procurement for its public industries, or do we buy salmon that has been caught in copper-coated nets that do not meet the standards that prevail in Scotland? It would be perfectly possible to do that.

Carrying capacity has been mentioned, most recently by Sarah Boyack. The carrying capacity of our lochs to hold the fish that we grow through aquaculture is important, but so is the carrying capacity of food-stock sources, and I ask the minister to raise the priority of research into that subject.

16:30

S2M-264 Defence Aviation Repair Agency

The Deputy Presiding Officer (Trish Godman): The final item of business today is a members' business debate on motion S2M-264, in the name of Roseanna Cunningham. The debate will be concluded without any question being put.

Motion debated,

That the Parliament notes the continued speculation about the impact of the Ministry of Defence's 'End to End Review' on the future of the Defence Aviation Repair Agency (DARA) in Almondbank; is concerned about the threat to the 325 jobs at the facility; recognises the important and specialised skills of the workforce there which are significant to both Perthshire locally and Scotland as a whole; acknowledges the massive local economic impact of DARA in Almondbank as evidenced by the Mackay Consultants' report of August 2003; further notes the cross party and multi-agency Welsh campaign to defend DARA jobs in Wales, and believes that the Scottish Executive should ensure that a similar campaign is organised in Scotland in order to protect and defend the continued existence of defence jobs at DARA in Almondbank.

17:12

... ... ...

17:28

Stewart Stevenson (Banff and Buchan) (SNP): Jackie Baillie is being disingenuous. She knows perfectly well that the Scottish defence forces in an independent Scotland would retain roughly the same number of employees as are currently employed—some 25,000 people. My colleague, John Swinney, will say more about that in his speech. I shall focus on some of the defence facilities in Scotland and the costs to wider Scotland of the country's being used for defence.

One third of lower air space in Scotland is reserved for military flying. That is good. We have the opportunity to provide that facility to other NATO countries, such as the United States and Germany, whose aircraft are regularly seen flying around the treetops in constituencies in the North of Scotland. However, the price for that is paid by the local people who live in those areas—a price that is paid also in military flying areas in the Borders—and there is no concomitant benefit in jobs on the ground from that activity. Nevertheless, the major facilities at Lossie, Kinloss and Leuchars bring tremendous economic benefit to the local communities. Those communities understand the price that they pay in noise and disruption and recognise the local benefits that they acquire.

It is not just my colleague Roseanna Cunningham's constituency that is being affected by closures. Jobs have been lost in the minister's constituency, with the recent closure of radar facilities at RAF Saxa Vord. Therefore, I hope that he will show an understanding of Roseanna Cunningham's position.

Strange things have happened, such as the aerodrome at West Freugh in south-west Scotland being closed with less than 24 hours' notice, which meant that three civilian planes found themselves locked behind the gates and were unable to get out for a week. Therefore, I think that we are right to be concerned about the jobs at Almondbank and to act pre-emptively to defend them.

We lost military contracts at Rosyth but recently gained some on the Clyde, which is good news. However, at Tain, to the north of Inverness, live munitions are dropped within sight and sound of the local community. Aircraft come from Germany to do that, but they do not stop in Scotland to refuel, nor do they bring any other benefits. Many of the costs that are borne by communities throughout Scotland to support the military are not matched by concomitant benefits. It is on that basis that I am happy to make a brief speech in defence of the facilities in Roseanna Cunningham's constituency.

We need our fair share. One of the things that the unionists always tell us is that there are benefits from being in the union, but there are also disbenefits, if we are not getting our fair share. I hope that the minister will be able to reassure us that his Executive and members throughout Parliament will be able to unite in a vigorous campaign to ensure that we retain the important jobs at Almondbank.

17:31

S2M-293 Closing the Opportunity Gap

The Presiding Officer (Mr George Reid): Good morning. The first item of business is a debate on motion S2M-293, in the name of Margaret Curran, on closing the opportunity gap. There are three amendments to the motion.

09:30

... ... ...

12:13

Stewart Stevenson (Banff and Buchan) (SNP): The Executive's document, "Closing the Opportunity Gap", states:

"Many of the obstacles which people face are deep-seated and complex. But that is not an excuse for shirking responsibility."

I am sure that that thought will be shared across the chamber. It is good to hear passion on a subject in the Parliament because, too often, our debates are anodyne, mundane and without passion. I congratulate Des McNulty for his most passionate contribution; I will return to the content of what he said later. If we cannot bring passion to the subject of the lives of ordinary people and of those with the fewest advantages in our society, we deserve opprobrium and contempt from the wider community.

The Executive's document has many words in it. I have not counted them, but I counted 28 objectives and 68 targets. I must point out, however—just to give a scale and a context—that the aggregate funding to support those targets and achieve those objectives over three years is less than the aggregate shortfall in spending in the Scottish Executive's budget over the past three years. That puts in context our preparedness to tackle the opportunity gap in our society.

Let us make some other comparisons that might illuminate today's debate. In 1979, the Labour party had been in power in the United Kingdom for five years, so let us ask some questions about then and now. In 1979, was there a dental health service in Scotland? Today, do poor people and others across Scotland have effective access to dental health on the NHS? In 1979, could the poorer families in our society afford for their children to go into higher education? Would those children end up educated and able to take their place in the world unburdened by debts? In 1979, yes; now, no.

Maureen Macmillan: Perhaps Stewart Stevenson will tell us how many people could access higher education in those days compared with now.

Stewart Stevenson: Of course we have made progress. The number of people in higher education has risen but, in opening up access to more people, we have disadvantaged those from poorer families by burdening them with a lifetime of debt after they have achieved their tertiary education qualification.

Johann Lamont is obviously intent on joining the select group of members who have returned from the summer break with injuries of one sort or another. She chose to shoot herself in the foot in a very cavalier fashion when she said that, if anyone knew how to persuade a child to take a free school meal, she would like to hear from them. Her Executive colleagues appear to think that they can do so. Their document states that they will

"By 2006 ... increase take-up, especially among pupils eligible for a free school meal."

I hope that the Executive is right—

Johann Lamont rose—

Stewart Stevenson: Yes, come on, Johann. Put them up; I will knock them down.

Johann Lamont: The issue is complex. There is a difference between making somebody eligible for a nutritious meal and making them eat it. Improving nutrition is more complex than simply providing it free. If somebody could get my daughter to eat a nutritious meal, for a start I would bless them, but I could afford to pay for that meal. The free school meal might help her nutrition, but it would necessarily trap resources that could help children who are in poorer circumstances than my daughter's. The only point that I was making is that the issue is complex and not as simple as is sometimes suggested.

Stewart Stevenson: I agree with every word that Johann Lamont has said, but I return to the Executive's claim that it will

"increase take-up, especially among pupils eligible for a free school meal."

The Executive seems to have the answer, but I share Johann Lamont's scepticism.

Des McNulty talked about the 1920s and how we have overcome absolute poverty according to its 1920s definition. The interesting thing about that is that absolute poverty obviously has a different definition today. We can play around with numbers—Mr Monteith made a bold attempt to do so—but the bottom line is that, when the Executive came to power in 1999, it used absolute poverty, as then defined, as one of its measures for success. The Executive has clearly failed on that measure.

Des McNulty criticised John Swinney for focusing on economics in yesterday's debate and not mentioning poverty—

Dr Murray rose—

Stewart Stevenson: I do not have time.

However, Des McNulty went on to talk about a laudable Clydeside project, which is an economic and social project. That is an important point, as it illustrates the complexities and difficulties of the subject of today's debate.

The minister got very aerated when the word "fraud" appeared in the debate in connection with SIPs. When The Scotsman used that word on 19 May in its report on SIPs, I am afraid that that was the word that seemed to meet the need. The Chamber's dictionary that we have in the chamber gives "deceit" as its first definition of fraud.

The Deputy Minister for Communities (Mrs Mary Mulligan) rose—

Stewart Stevenson: I really do not have time. The minister will have time in her summing up.

As I said, the first definition of fraud is deceit. We are deceiving people as to what the SIPs can achieve. I think that it was Gerry Hassan who said that SIPs

"are seen as the champions of the people and the down-trodden, but are really looking after their own interests".

Indeed, the core of the debate is the question of the way in which the Scottish Parliament behaves and how others at Westminster have behaved. Would the Scottish Parliament have chosen, as the Inland Revenue has chosen, to sell off its physical assets to a tax haven, thereby reducing the money available for this and many other subjects?

It is interesting to note that we have heard not a single word in the debate about the disabled. As MSPs, we featherbed ourselves. If an MSP is, or becomes, disabled, support is provided for as long as that MSP is a member of the Parliament. In the wider world, support is provided for three years. We have heard something about pensions today. As MSPs, we earn one fiftieth of our salary each year for our pension. Out there, teachers get an eightieth and in the wider community, few people get anything at all.

The poverty that contains the poor is many faceted. One of the things over which the Scottish Parliament has no power is the high marginal tax rate of those in benefit. As MSPs, we pay a 40 per cent marginal tax rate on our earnings, but the poor often pay between 90 and 95 per cent. Examples such as that illustrate the poverty of ambition to take on the real powers of a normal country and of a normal Parliament and to start to solve our problems and deliver for the poor in Scotland.

12:22