Good afternoon. The first item of business is consideration of business motion S5M-08101, in the name of Joe FitzPatrick, on behalf of the Parliamentary Bureau, setting out a revised business programme for Thursday.
That the Parliament agrees to the following revision to the programme of business for Thursday 5 October 2017—
2.30 pm Parliamentary Bureau Motions
2.30 pm Ministerial Statement: Scottish City Region Deals – Next Steps
2.00 pm Parliamentary Bureau Motions
2.00 pm Ministerial Statement: Air Departure Tax: Update
followed by Ministerial Statement: Scottish City Region Deals – Next Steps—[Joe FitzPatrick.]
Motion agreed to.
Portfolio Question Time
Sports Clubs and Leisure Centres
To ask the Scottish Government what role sports clubs and leisure centres play in maintaining a healthy lifestyle. (S5O-01315)
Sports clubs and leisure centres play an important role in helping people to maintain a healthy lifestyle. People of all ages and abilities can benefit from participating in sport and physical activity to improve both their physical and their mental health.
The Barclay review has floated the recommendation of ending rates relief for arm’s-length external organisations such as Edinburgh Leisure. That could foot them with a bill of millions of pounds. If the Scottish Government decides to implement that recommendation, is the minister concerned about the potential effects on health if public leisure facilities are stripped back or made more expensive as a result?
I am well aware of the good work that Edinburgh Leisure carries out. I met representatives of Edinburgh Leisure and saw at first hand some of the interesting and innovative work that it has been doing to try to get the inactive active. When the Cabinet Secretary for Finance and the Constitution made his statement on 12 September, he accepted the majority of the recommendations, but there are certain recommendations and points of detail that he is now considering further, and he is engaging with relevant stakeholders ahead of publishing an implementation plan by the end of the year. We will continue to engage further with members on that point of interest, and we would be happy to meet Gordon Lindhurst if he so wishes, but the cabinet secretary is still considering some specific points of the Barclay recommendations, and the point that the member has raised is one of the issues to which he is giving further consideration.
The minister will be aware of the great success of the Gladiator weightlifting club, based in Easterhouse in my constituency, which won gold and bronze medals at the recent Commonwealth youth championships in Australia. The minister will also be aware that the young medal winners and their teammates had to raise funds themselves to pay for the trip, because no official funding was available. What steps are being taken to ensure that funding for sport finds its way to grass-roots sports clubs such as the Gladiator weightlifting and Phoenix boxing clubs in Easterhouse and in other socially deprived areas of the country, so that the Commonwealth games legacy can deliver increased sports opportunities for young people who might not otherwise be able to participate?
One of the big planks of the Commonwealth games was appropriate planning for the legacy of the games to be felt not just across Glasgow but throughout the country, and ensuring that the legacy reaches areas of deprivation is an important concern. Via sportscotland, clubs from across Scotland are able to access support through various funding streams, direct club investment, awards for all and the facilities fund. As well as that, sportscotland is committing additional support to the seven community sports hubs that are based in the areas of highest deprivation.
With regard to Ivan McKee’s specific question about weightlifting, I am happy to meet him to discuss support for weightlifting clubs in his constituency, and I commend the weightlifting club based in Easterhouse on the gold medal and bronze medal from the Commonwealth championships. I look forward to meeting the member to discuss the wider issues.
HIV (Information in Schools)
To ask the Scottish Government what role national health service boards can play in ensuring that young people receive information at school that will reduce their risk of contracting HIV. (S5O-01316)
Relationships, sexual health and parenthood education is key to ensuring that all young people across Scotland make healthy choices with regard to their sexual health, including knowing how to protect themselves from HIV. NHS boards work with local authorities and other partners to support the delivery of high-quality, consistent and inclusive RSHP education in schools across Scotland, and boards can also play a role in supporting the training of teaching staff delivering RSHP education, ensuring that schools are aware of NHS services for young people in their areas and directly participating in the co-delivery of teaching sessions by NHS staff.
NHS boards are also working with local authorities on a national RSHP resource to support effective RSHP teaching. That new resource will cover a range of issues including consent, healthy relationships and the impact of digital technology, and it will also be fully inclusive of lesbian, gay, bisexual, transgender and intersex issues.
Today, HIV Scotland was announced as winner of a prestigious British Medical Association award for improving HIV healthcare. Its recent report “HIV and Education: Guaranteeing Lessons for All” highlighted that, every month, two young people are diagnosed as being HIV positive. Is it time that we had stronger partnership working between health boards, local authorities and the third sector to ensure that young people receive the best information on how to lead long and healthy lives? Does the minister agree that this is a public health issue?
I certainly commend HIV Scotland for winning that award and for the work that it does in this area. I also welcome the organisation’s report, because, as the member has highlighted, HIV prevention absolutely remains a public health challenge and NHS boards will continue to work with schools and local authorities to deliver change and stage appropriate RSHP education on the risks of HIV. There is an opportunity in the work that is being taken forward by boards and authorities on the new RSHP resource, but we also need to consider wider opportunities to properly engage people on safe-sex messages, such as those around the administration of pre-exposure prophylaxis. We should consider all such opportunities, and we will certainly build on HIV Scotland’s good work and the work that is under way across authorities and NHS boards.
This year marks the 30th anniversary of the first broadcast of the AIDS “Don’t die of ignorance” public health advertisement, which, with its macabre imagery and alarming tones, cemented in the minds of a generation the idea that an HIV diagnosis meant almost certain death. Unfortunately, it still informs perceptions to this day. Given that HIV has not been the death sentence that it once was since the introduction of highly active antiretroviral therapy in 1996, does the minister agree that ensuring that young people are aware that HIV is now a manageable medical condition is essential to tackling the HIV stigma that sadly persists to this day?
Tom Arthur has articulated the memories that many of us have of the HIV campaigns of the 1980s. Although I agree that we need to continue to raise awareness of HIV risks, prevention and treatment, we also need to look at tackling the stigma and discrimination that are so associated with contracting HIV. I believe that there was a cross-party group in this Parliament whose specific ask was that we did not lose sight of the stigma that many people with HIV continue to face in our country, and I think that, across the parties, we will agree on the need to be resolute in tackling the discrimination that too many people face.
NHS Lanarkshire (Meetings)
To ask the Scottish Government when it will next meet NHS Lanarkshire. (S5O-01317)
Ministers and Scottish Government officials regularly meet representatives of all health boards, including NHS Lanarkshire, to discuss matters of importance to local people.
There is one important issue that I feel should be raised at the next meeting with NHS Lanarkshire. Is the minister aware that although Kilbryde Hospice opened to day patients some time ago, it has in-patient beds that are not being utilised? The situation is really frustrating for all the volunteers and local residents who worked to bring the hospice to East Kilbride and Lanarkshire. Will the minster intervene and raise the matter to bring clarity to the situation and, I hope, ensure provision of hospice in-patient beds in East Kilbride and South Lanarkshire?
I have been made aware of the situation, and I am happy to meet the member to discuss it further, if she so wishes. I think that she knows that the health and social care partnerships in South and North Lanarkshire are working together to agree on how to make best use of local palliative care services and supports to meet their populations’ needs.
Earlier this year, NHS Lanarkshire established a short-life working group to consider how best to do that, and I understand that the group will shortly share its recommendations, with a view to engaging further with stakeholders in the near future. Following that, a proposed way forward will be presented to the North and South Lanarkshire integration joint boards, which I hope will be before the end of this year.
In 2009-10, NHS Lanarkshire spent £13,000 on agency nurses but, by 2016-17, that had rocketed to more than £1.8 million. Over the same period, the number of unfilled nursing and midwifery vacancies in Lanarkshire increased from 18 to 254. Does the minister agree that a major contributory factor in that was Nicola Sturgeon’s decision when she was health secretary to slash training places for nurses? What will the minister do to rectify that situation and ensure that Lanarkshire hospitals are not chronically understaffed?
As the member knows, NHS agency spend is an extremely small part of the overall health budget. As he also knows, we are currently working on NHS workforce planning.
In relation to Linda Fabiani’s question, perhaps the member would like to join me in congratulating nurses in the field of palliative care and in recognising a report from the University of Bath, the lead author of which says that Scotland is “leading the way” with ambitious targets on palliative care and reorganisation and is a place to come to on that.
I whole-heartedly agree with Linda Fabiani. I know that the Lyons family, who lost a much-loved father and husband, Frank Lyons, who was a motor neurone disease campaigner, would really appreciate it if that point was followed up.
Is the minister aware that ward 18 at Hairmyres hospital in East Kilbride, which is a care of the elderly ward, has been closed to new admissions? Can she clarify whether that has resulted in a reduction in the number of available beds for elderly patients at Hairmyres and whether the measure is permanent?
I am not aware of that issue about ward 18, but I am happy to investigate the issue and write to the member with information on it.
National Health Service Resource Allocation Formula
To ask the Scottish Government what plans it has to review the NHS resource allocation formula. (S5O-01318)
The national resource allocation formula is updated every year to take account of changing demographics across Scotland. The most recent review, relating to the morbidity and life circumstances adjustment for the acute care programme, was reflected in the NRAC shares issued for 2017-18 onwards.
Vacancies and long waiting lists are leading to NHS Grampian patients potentially being sent as far as Newcastle for surgery. Under the allocation formula, NHS Grampian receives only 89p per head, compared with the national average of £1, which is a smaller share than it received a decade ago. The board also lost £15 million in the last financial year. Does the cabinet secretary accept that funding decisions made by the Government are causing delays and crisis in the north-east? When will the Scottish Government fund NHS Grampian at the level that the Government’s own allocation formula requires?
NHS Grampian’s resource budget for 2017-18 has increased to £898.6 million, which includes an additional £3 million of NRAC parity funding. Such funding ensures that no board is further than 1 per cent from its target share of funding. Since 2015-16, NHS Grampian has received additional funding of £47 million for the specific purpose of accelerating funding parity in line with the NRAC formula. Grampian has been one of the biggest gainers from the formula in recent years.
On the point about patients being sent to Newcastle, that arrangement is clearly part of a process of boards helping one another. Glasgow and Edinburgh are the first ports of call for patients from Grampian, to support Grampian while it recruits and works its way through some of its difficulties. Newcastle is the third option. I am sure that neither Liam Kerr nor anyone else in the chamber would suggest that we should not utilise resources wherever they are offered. This is not the first time that mutual aid has been given north and south of the border. That approach is to be welcomed and I certainly applaud Grampian’s efforts in doing that while it sorts out the recruitment issues in its area.
The health secretary must recognise that resource is not meeting demand in the NHS. Health boards are telling us that they are having to make more than £1 billion-worth of cuts over the next four years, and that is having devastating consequences on the workforce and on patient care.
One shocking example of that is the revelation that women in Glasgow who suffer a miscarriage are having to wait up to five weeks to have a surgical removal of the foetus. That is a shocking and heartbreaking revelation. What will it take for the cabinet secretary to wake up, realise that there is a problem in the NHS and give patients and NHS staff the treatment that they deserve?
Anas Sarwar raises two very different issues, and I will take the first one first. He will be aware that there are more resources going into the NHS than there ever have been before. Of course, under Labour’s proposals in its 2016 election manifesto, less money would be going into the NHS than we are delivering. However, he makes a point with which I would agree, which is that demand for the NHS continues to grow and put pressure on services, which is why we need to reform the way in which services are organised. We are working through the integration partnerships to ensure that more people avoid admission and are kept out of hospital, which is very important, given the growing frail elderly population.
Anas Sarwar spoke about a very serious case in NHS Greater Glasgow and Clyde that has been raised over recent days. I understand that a complaint has been raised about the case and a full investigation is going on, and I have asked the chief medical officer to look into the issue in Glasgow and the rest of Scotland. The initial indications from Glasgow and Clyde are that it is an isolated case. It is totally unacceptable and I am determined that we will absolutely not accept that standard of healthcare for anybody anywhere in Scotland, but it is not reflective of the rest of the service in Glasgow and Clyde. The chief medical officer is seeking assurance on the issue not just in Glasgow and Clyde but elsewhere, because I want to ensure that women across Scotland get the highest level of care, particularly in very sensitive circumstances such as this.
NHS Grampian (Cancelled Operations)
Does the minister not see that with 3,500 fewer planned operations, the second-worst waiting times record—
Mr Rumbles, you have to read your first question first. I think that you are on your supplementary.
To ask the Scottish Government what its position is on the number of planned operations that have been cancelled in NHS Grampian. (S5O-01319)
The decision to cancel a patient’s operation is never taken lightly. All boards, including Grampian, work very hard to keep cancellations to a minimum, and we continue to work with them to see sustained improvements.
It is important to remember that cancellations are a small percentage of the overall number of planned operations taking place. The latest cancelled operations figures, which are for August, show that in Grampian 1,947 operations were carried out and 83 operations were cancelled due to capacity or non-clinical reasons.
We have seen 3,471 fewer planned operations, the second-worst waiting times record of any national health service board, hundreds of cancelled operations for non-clinical reasons, and, most recently, specialist veterans services pulling down their shutters due to a lack of funding support from NHS Grampian. I am not the only Grampian MSP raising the issue. Does the cabinet secretary not believe that now is the time to fund NHS Grampian properly? It receives only 89 per cent of the average funding per head of population. The problem is not the amount of money that the cabinet secretary has mentioned; the share of the budget needs to be addressed.
As I said in my answer to Liam Kerr, NHS Scotland resource allocation committee funding has been an important element of the funding that Grampian has received in recognition of the challenges that it faces. Since 2015-16, it has received additional funding of £47 million for the specific purpose of accelerating funding parity in line with the NRAC formula.
As I said, a very small number of operations are cancelled due to capacity or non-clinical reasons—for August, that amounted to 2.8 per cent. A number of other operations are cancelled for clinical reasons or because patients are not fit to have the procedure, or are cancelled by patients. The vast majority of operations go ahead.
Mike Rumbles mentioned the veterans services, which have been important. We have supported boards to continue to provide veterans services in a very difficult backdrop, because they were previously funded through London interbank offered rate—LIBOR—money; as Mike Rumbles will be aware, that money has been withdrawn. We have tried to help boards to sustain those services and have offered them a partnership arrangement for funding. It is up to those boards to either accept or not accept; most have, but a small number have not decided to go down that route. That is a local decision for those boards.
What measures have been taken by NHS Grampian, in conjunction with local universities and colleges, to train more theatre staff for Aberdeen royal infirmary to address staffing issues?
Gillian Martin touches on an important point, because a key issue for NHS Grampian is its ability to recruit and retain staff, in particular theatre staff for Aberdeen royal infirmary. The board is taking a number of important measures to plan and sustain its theatre workforce; for example, it is one of a number of boards that have piloted a new approach to developing the theatre workforce. It is working in partnership with the north-east of Scotland colleges to develop and deliver a professional development award in perioperative practice, which has enabled existing theatre staff to further develop their skills and experience, ensuring a clearer career pathway and helping to attract and retain theatre staff.
A lot of work is going on; the board has entirely restructured the way in which it organises its theatres in the Grampian area and I am confident that, over time, it will be able to build up its capacity and to sustain and provide quicker access to procedures than it currently provides.
We have heard a lot of information from the cabinet secretary about how many extra resources are going in and about the partnership arrangements with Newcastle, Glasgow and Edinburgh. We have not heard how long this will go on for; it has gone on for several years so far. Will she give the north-east of Scotland a promise on when things will normalise, when there will not be cancellations and when waiting lists will come down to what could be considered a normal level?
The arrangements for cardiac patients are new and have not gone on for years. The board had to come to those arrangements because of the particular issues of not being able to recruit to those specialties within the Grampian area. It is important to make sure that cardiac patients in the Grampian area in the north of Scotland get access to the cardiac specialists that they need, so that is why the board has come up with the important arrangements with Glasgow, Edinburgh and Newcastle—although it has not had to utilise any capacity in Newcastle so far.
The most important people in all this are the cardiac patients. I know that they would want to get their treatment as quickly as possible, and, if that means travelling outwith Grampian, I am sure that that is what they are prepared to do. Meanwhile, NHS Grampian is working very hard to try to recruit those specialists to Grampian, so that it can get its service back up and running to be able to meet the demands from the Grampian area.
Question 6 has not been lodged.
Access to New Medicines
To ask the Scottish Government what action it is taking to increase access to new medicines. (S5O-01321)
In December 2016, Dr Brian Montgomery published his independent review on access to new medicines, which recognised that the Scottish Government has made significant reforms and investment to improve access to newly licensed medicines in recent years. The review found that, following our previous reforms, Scottish Medicines Consortium acceptance rates increased markedly.
We are committed to continuing to build on those improvements and are taking forward the recommendations set out in Dr Montgomery’s report. We are working in collaboration with stakeholders, including the SMC, NHS Scotland and the pharmaceutical industry, to implement the recommendations as quickly as possible. We encourage drug manufacturers to make reforms too, so that they bring forward medicines at a fair price.
I thank the cabinet secretary for her answer, especially the part about the pharmaceutical industry and fair prices.
I know that the cabinet secretary will be as aware as members and the public are that working across countries is important in accessing new medicines. What impact will leaving the single market have on our access to new treatments and medicines?
That is an important issue. Should the United Kingdom choose to take us out of the single market and withdraw our membership of the European Medicines Agency, there is a clear risk that pharmaceutical companies could be less committed to the UK market than they would be to the larger attractions of the European Union and the United States, and that patients in Scotland and the wider UK could face delays in accessing the medicines that they needed within the timescales that we currently enjoy as a full member of the EU.
I am also concerned that medicine manufacturers could be negatively impacted by additional costs as a result of having to work separately with the UK. As a result, some manufacturers could choose not to work with the UK all, or could increase the costs of our medicines.
In light of all that, in July, I wrote to the Secretary of State for Health, Jeremy Hunt, seeking clarity on the UK’s future relationship with the European Medicines Agency. I have also requested the full and regular involvement of the Scottish Government in those crucial discussions and decisions.
Will the cabinet secretary give an update to my constituents and to members on what steps the Scottish Government is taking to allay the fears of cystic fibrosis patients who are campaigning for access to the drug Orkambi?
Miles Briggs will be aware that decisions made by the Scottish Medicines Consortium have been and continue to be independent of ministers and Parliament. Those decisions are based on clinical issues and cost effectiveness at a national population level for all of Scotland.
In March, I wrote to Vertex Pharmaceuticals to encourage it to hold discussions about the cost of Orkambi with colleagues in the NHS National Services division who are best placed to advise the company on pricing approaches and a fair price that could support the securing of a positive recommendation from the SMC for the prescribing of such products in the NHS in Scotland. The talks are under way and I am sure the member will agree that we should allow them to continue.
Through those discussions, I hope that the manufacturer will make its best offer on price and indicate that it will resubmit an application to the SMC at the earliest possible opportunity.
Will the Scottish Government consider funding Sativex, a cannabis-based medicine, as NHS Wales has done? Drugs such as Sativex can help to treat multiple sclerosis, arthritis and other musculoskeletal conditions.
Tony Wiggins, the chair of the Cardiff and Vale MS Society, has trialled Sativex and called it a “tremendous step forward”. He also said:
“It’s good for spasms and other effects of MS—and it does work”.
I realise that Sativex is not authorised by the SMC but the cabinet secretary will be aware that doctors can prescribe it should they wish to. However, will she consider going down the same road as Wales?
As Pauline McNeill said, when the SMC decides not to accept a medicine for routine use, clinicians can still request access to it for their patients on an individual case-by-case basis when they feel that it would be of significant clinical benefit. That is currently done through the individual patient treatment request system, which is changing to the new peer-approved clinical system. The new system will improve consistency and ensure that patients get access to the right treatment at the right time, and there will be a national appeal panel to ensure greater equity of access. For the patients Pauline McNeill is talking about, that route would be the suggestion. They could also make a further submission to the SMC. I am not sure whether there are plans to do that with any specific cases, but I could certainly write to Pauline McNeill with that information.
The information requested is not held centrally. However, my officials have contacted the board and I understand that more than £1 million is available to cover GP vacancies and single-handed GP leave cover in NHS Shetland.
The island of Yell used to have two GPs running an independent practice. To save money, locum cover is now to be replaced by an advanced nurse practitioner. Does the cabinet secretary accept that that will put a clinical burden on that individual, who will have to refer cases to a GP in Lerwick by phone? Is that acceptable? Would it not be better to have a GP on the island of Yell?
I am aware that there have been challenges and difficulties in trying to recruit to a number of GP posts in the area. A lot of work has gone on to try to incentivise some of those posts. I am sure that Tavish Scott is aware of that work. I also understand that a successful GP training scheme is being run through the Lerwick practice, with four GP registrars currently in training and due to qualify in about 18 months’ time. Those people want to stay in Shetland, although where they will end up being located is a matter for discussion.
The role of advanced nurse practitioners is important. I know that that is being considered as a way of addressing GP recruitment issues. Of course, those people are experienced nurses in their own right. The issue of the clinical back-up that they have is important, and they should have access to that GP support.
I am happy to discuss these issues further with Tavish Scott. If we can help, through the rural medicine collaborative and other incentives, I would hope that NHS Shetland would take advantage of that.
NHS Dumfries and Galloway
To ask the Scottish Government what recent discussions it has had with NHS Dumfries and Galloway regarding equity and equality of service across its area. (S5O-01323)
The Scottish Government has regular contact and discussion with NHS Dumfries and Galloway, and it was in contact last week as part of the board’s annual review. At that meeting, a range of topics were covered, including performance, finance, the new £200 million Dumfries and Galloway royal infirmary and the positive on-going engagement with the integration joint board.
The cabinet secretary will be aware of the cross-party petition, which has received widespread support in Stranraer and Wigtownshire, that seeks a long-term commitment from the Scottish Government to the retention and improvement of services in the Galloway community hospital. I thank the cabinet secretary for accepting my invitation to come to Stranraer to collect the petition and to hear the real concerns of local people.
Given the ever-increasing pressure on hospital bed numbers, does the cabinet secretary agree that cottage hospitals play a vital role in transitioning patients from hospital to their homes? Can she confirm that there are no plans to close any cottage hospitals in Galloway and west Dumfries?
I am fully aware of the strength of local feeling in support of Galloway community hospital—not only Finlay Carson but all local members have made me aware of that. The temporary changes over the summer were made in order to ensure patient safety, and services at Galloway community hospital are now running as normal, which I hope the member welcomes.
The board has worked hard to overcome some of the recruitment and retention issues at the hospital. The hospital is valued and provides high-quality services, including services well beyond those that are found in other community hospitals.
NHS Dumfries and Galloway has given assurances that it will continue to keep local communities fully informed of any changes to services at the hospital, when those are unavoidable for patient safety reasons, and it is keen to engage with local people and their representatives. In July, it held a public meeting to discuss the issues, which I understand was productive.
I remind the chamber that I am a registered nurse.
Does the cabinet secretary agree that health boards have a duty to undertake any service redesign in close consultation with stakeholders including patients and parliamentarians?
Yes. Emma Harper has raised the issue on a number of occasions. Boards have a duty to carry out full and meaningful engagement with all stakeholders when they consider taking forward any service change proposals, in line with well-established Scottish Government guidance.
It is also important that boards engage anyway, not just around service change proposals. One issue that emerged from the public meeting with the board about Galloway community hospital in July was the need for full information to be provided. People appreciate that, due to staff sickness or other issues, unavoidable challenges sometimes arise that require the board to ensure that services continue to be provided in a safe way. However, the board also needs to make sure that the information is provided in full and that the community is fully aware of any changes. Dumfries and Galloway NHS Board has learned a lesson from the experience at Galloway community hospital.
Does the cabinet secretary accept that the biggest challenge in delivering equity and equality of service in a rural area such as Dumfries and Galloway is the current NHS recruitment crisis? In that region, there are 150 nursing and midwifery vacancies, 28 allied health professional vacancies and 28 consultant vacancies, which is 22 per cent of all such posts. In addition, 42 per cent of GP practices in the region have an unfilled GP post. The recent Audit Scotland report on workforce planning revealed that two thirds of interviews for consultant posts in the region were cancelled because of a lack of suitable applicants. When is the Scottish Government going to take responsibility for letting down patients in Dumfries and Galloway, and will it apologise for 10 years of abject failure to ensure proper NHS workforce planning?
Like other health boards, NHS Dumfries and Galloway has more staff than it has ever had. It also has more posts than it has ever had. However, there are vacancy issues within certain areas of the country, particularly in more remote and rural areas. That is why we are trying to attract staff to come to Scotland and making sure that we train enough staff. It is why, over the past five years, we have increased the number of nursing and midwifery training posts, and it is why we are expanding the number of undergraduate medical courses and adding a new graduate medical school. It is also why we published a workforce plan in the summer, through which we will work with boards to ensure that we have the staff going forward.
We are not the only part of the country to have issues with recruitment and retention. Those are issues for all health systems in the United Kingdom and beyond, as some specialties are very difficult to recruit to. NHS Dumfries and Galloway is no different in that respect. Therefore, we will continue to support the board to successfully recruit and retain staff.
As members will be aware, we are working hard on the GP issue through our work on the new GP contract, which will make a real difference by attracting GPs to come and work in Scotland and by making general practice an attractive career for young doctors.
Question 10 has not been lodged.
Medical Professionals (Freedom of Movement)
To ask the Scottish Government what its position is on the Law Society of Scotland’s warning that ending freedom of movement may deter medical professionals from moving here and have implications for people already living and working here. (S5O-01325)
I remind the chamber that I am a registered nurse.
Scotland’s health workforce benefits enormously from the contribution that is made by staff from across the European Union, and we need to retain the ability to recruit freely from that diverse and experienced talent pool. I agree with the Law Society that any restrictions on the current free movement arrangements will inevitably pose recruitment and retention challenges for health boards.
I have met a number of EU staff directly, who have told me of colleagues who have already left Scotland. Staff are understandably anxious and uncertain about the impact of Brexit on their right to live and work in Scotland. Therefore, we urgently need clarity from the UK Government on future immigration policy.
The Scottish Government has signalled its desire to retain freedom of movement and access to the single market, and we will continue to do all that we can to protect Scotland’s interests in Europe.
Does the cabinet secretary agree that we need urgent clarity on what the rights of EU nationals who are working in the national health service will be after we are taken out of the EU?
Yes, I do. A number of members have raised issues about recruitment and retention, and it is important that the Scottish Government does everything it can to grow the workforce in Scotland. We are doing that by expanding the number of training places in nursing, in medicine and elsewhere.
Stopping the flow to Scotland of EU nationals, who are an extremely important part of the workforce both for the here and now and for the future, is a retrograde step that will make the situation in Scotland much worse. I send out the message to EU citizens who are living here that they are very welcome and that we want them to stay. Indeed, we want future generations of EU citizens to come here and work in our health and care services.
The next item of business is a statement by Jamie Hepburn on delivering employment support for Scotland. The minister will take questions at the end of his statement, so there should be no interruptions or interventions.14:40
I welcome this opportunity to update Parliament on progress towards the delivery of the fair start Scotland employment support service, one of the first powers devolved under the Scotland Act 2016. This is an important milestone for employment support in Scotland and an opportunity to make employment services work differently and more effectively for the people of Scotland. The Scottish Government is already using new powers to deliver one-year transitional employment support services and those are already helping unemployed people with health conditions and disabilities across the country to find work and to stay in work. Those services are providing continuity of support while we progress towards delivering fair start Scotland from April 2018.
We all understand the health, social and economic benefits of getting more people into good, rewarding and fair work. That is at the heart of our ambition to deliver inclusive economic growth. That ambition is laid out in our economic and labour market strategies and demonstrated through our commitment to the fair work agenda being promoted by the fair work convention; and that ambition is writ through fair start Scotland as well.
Today, following the conclusion of a rigorous and open procurement process, I can announce that we have signed contracts for up to five years to deliver fair start Scotland from April next year. Fair start Scotland will provide tailored, person-centred support to a minimum of 38,000 people who are further removed from the labour market and for whom work is a realistic prospect.
Before I outline the successful bids, I thank all the organisations that have taken part in the process. Engaging in any procurement process requires a significant investment and, whilst I know that those who have secured the contracts will have been pleased to do so, there will be others who feel that they have missed out. Every bid that we received showed the real commitment, dedication and desire of organisations in the public, private and third sectors to help support people into work. I appreciate the work that all those involved put into the process.
In announcing who has been successful today, I am confident that we have been able to award contracts to a range of providers that have demonstrated strong, collaborative proposals that will deliver our shared ambitions. Let me now outline the detail of the nine contracts that I am announcing today.
Contract area 1 covers the city of Glasgow. The contract has been awarded to PeoplePlus Group Ltd, to be delivered in partnership with Remploy Ltd, and third sector partners Momentum Scotland and the Lennox Partnership. The estimated value of the contract is £19.1 million.
Contract area 2 covers the North Lanarkshire and South Lanarkshire local authority areas. The contract has been awarded to Remploy Ltd, to be delivered in partnership with third sector partners Enable Scotland and Routes to Work South. The estimated value of the contract is £12.6 million.
Contract area 3 is Tayside and covers the Perth and Kinross, Angus and Dundee local authority areas. The contract has been awarded to Remploy Ltd, to be delivered in partnership with third sector partners Rathbone Training and the Wise Group. The estimated value of the contract is £7.3 million.
Contract Area 4 is Forth valley and covers the Falkirk, Stirling and Clackmannanshire local authority areas. The contract has been awarded to Falkirk Council, to be delivered in partnership with public sector partners Clackmannanshire Council, Stirling Council and NHS Forth Valley. The estimated value of the contract is £5 million.
Contract area 5 is the east and covers the Edinburgh, Midlothian, East and West Lothian, Fife and the Borders local authority areas. The contract has been awarded to Start Scotland Ltd, to be delivered in partnership with Working Links, Triage and third sector partner Momentum Scotland. The estimated value of the contract is £21.3 million.
Contract area 6 is the south-west and covers Dumfries and Galloway and the three Ayrshire local authority areas. The contract has been awarded to Start Scotland Ltd, to be delivered in partnership with Working Links and third sector partners Rathbone Training, the Lennox Partnership and the Wise Group. The estimated value of the contract is £10.1 million.
Contract area 7 is the north-east and covers the Aberdeen City and Aberdeenshire local authority areas. The contract has been awarded to third sector organisation Momentum Scotland, to be delivered in partnership with Life Skills Centres Ltd and Enterprise Mentoring Ltd. The contract will be delivered alongside third sector partners Enable Scotland, Aberdeen Foyer and the Scottish Association for Mental Health. The estimated value of the contract is £5.6 million.
Contract area 8 is the Highlands and Islands and covers Argyll and Bute, Eilean Siar, Highland, Moray, Orkney and Shetland. The contract has been awarded to People Plus Ltd. It will be delivered in partnership with a mixture of public, private and third sector partners of Argyll and Bute Council, Life Skills Centres Ltd, Lochaber Hope, Momentum Scotland, Third Sector Hebrides and 20/20 Clearview Ltd. The estimated value of the contract is £6.2 million.
Finally, contract area 9 is the west and covers East and West Dunbartonshire, East Renfrewshire, Inverclyde and Renfrewshire. The contract has been awarded to third sector organisation the Wise Group and will be delivered in partnership with Working Links and third sector partners the Scottish Association for Mental Health, the Lennox Partnership, Enable Scotland and the Royal National Institute of Blind People. The estimated value of the contract is £8.8 million.
Under the provisions that we laid out, the contract for the west area was specifically reserved for supported businesses to bid into. This is the first time that we have exercised that power, demonstrating the Government’s commitment to that sector. Supported businesses provide vital permanent employment for those who are disadvantaged in the labour market. We are determined to develop a more diverse delivery market for employment support through devolution, and that is why our approach, unlike previous approaches, used devolved powers to reserve one area for bids from supported businesses. The Wise Group has secured that specific contract under the reservation for supported businesses in the west area, but we have also seen successful bids from a supported business, Remploy, in two other lots—Lanarkshire and Tayside—and involvement of both organisations in other areas as delivery partners, demonstrating the strength of that business model.
We evaluated the bids that we received in order to secure best quality and consistent provision across Scotland and we will rigorously performance manage the service to ensure that those are delivered. That is crucial to help us to ensure that there is continuous improvement in the public services that we can offer people.
We have listened in public consultation and in on-going stakeholder engagement, and we have listened to Scotland’s devolved employment services advisory group, which has helped to shape, develop and test our devolved employability approach. I place on record my thanks to the group’s chair, Professor Alan McGregor, and its third, private and public sector members.
As we enter the delivery phase of fair start Scotland, I confirm that I plan to develop that consultative approach further and to continue to listen to a diverse range of voices as we deliver the programme and a more aligned, wider employment support landscape. Fair start Scotland will see unprecedented levels of partnership delivery. The joint working that we will see between private, public and third sector delivery partners across Scotland will be a real strength of our new approach.
This is not simply business as usual. We are taking a partnership approach in Scotland that will see more than half of provision delivered by supported businesses and by third sector and public sector bodies. Although fair start Scotland has been designed nationally, all services will be delivered locally through new consortia and will feature a range of specialist providers to ensure that people receive the right type of support for them. We are taking a different approach from the United Kingdom Government by funding the services appropriately. We are committing an additional £20 million each year from our budget, over and above the significantly reduced funding that is being provided by the UK Government.
Today, I am laying out who will deliver our fair start Scotland programme through the contracts that have been awarded but, much more critically, we must remember that delivery of the programme is about providing support to people who need it. Our vision for fair start Scotland is clear and we are using devolved powers to deliver a distinct and different approach to employment support in Scotland. Our approach is significantly different from what has previously been seen in UK Government programmes. We are putting people at the centre of the services and treating them with dignity. Fair start Scotland will have respect and fairness at its core, supporting people to achieve their full potential.
We are listening to the views of people who rely on these services and we will continue to do so. We are better reflecting the reality of Scotland’s geography, regional economies and population spread by having nine contract areas rather than simply lumping the whole of Scotland together as one contract package area, as has been the case under the UK Government. We are also delivering differently by ensuring that providers have committed to a wider fair work, workforce and community benefits agenda as part of their bids, including by paying the living wage and avoiding the use of zero-hours contracts.
Also, crucially, as this Parliament has endorsed by overwhelming majority, fair start Scotland will be voluntary. It will work with unemployed people to encourage them to take the opportunity of support towards work and will not threaten them with sanctions from the Department for Work and Pensions. That is in keeping with our desire, running through all of our new employability and social security powers, to treat people with dignity and respect.
Our employment programmes are not about supporting organisations, sectors or institutions; they are above all about supporting people: people who deserve to be supported through a person-centred and tailored approach that meets their needs, who deserve to be supported to achieve their full potential, who deserve to be supported to enter work and to retain a job, and who deserve to be treated with dignity, respect and fairness and to get on in life.
Just as is the case with all of this Government’s endeavours, people will be at the core of our approach to taking forward fair start Scotland.
Thank you, minister. We now move to questions.
I thank the minister for early sight of his statement. I welcome much of it, as I welcomed the devolution of employability programmes in the Smith commission, but I am puzzled by one thing. David Semple of the Public and Commercial Services Union explained to the Social Security Committee last week his union’s absolute opposition to the involvement of the private sector in all devolved aspects of social security, including employability services. He said:
“our opposition is not ... ideologicial; it is based on performance. None of the privatised employability contracts have had the same delivery outcomes as previous state-run programmes.”—[Official Report, Social Security Committee, 28 September 2017; c 5.]
The minister knows that I do not agree with that, but I thought that Scottish ministers did. After all, Jeane Freeman has explained to loud applause in the chamber that devolved disability living allowance and personal independence payments will not be administered by the private sector. So why has Jamie Hepburn signed contracts not only with the private sector but, I note, with one of the very companies that delivered the work programme in Scotland, which is a programme that the minister has previously condemned? Is that not a case of the Scottish National Party saying one thing and doing quite another?
Let me begin by apologising for puzzling Professor Tomkins. That was certainly not my intention, though puzzled he seems to be. It is symptomatic of the Conservative Party’s approach to these matters. I appreciate that Professor Tomkins is the social security spokesperson for the Conservatives in this place, but we are treating employment support rather differently. We are not treating it as part and parcel of the social security system. Clearly, there has to be interaction between those two systems, but we are treating our employment service as an opportunity to support people to get them into work and not to tie them into a manipulative and unfair social security system that sanctions them at every turn.
In response to the point that Professor Tomkins has made—rather mean-spiritedly, I have to say—about me saying one thing and doing another, I remind him that in “Creating a Fairer Scotland: Employability Support: A Discussion Paper“, which we published on 6 July 2015, we set out that
“Scotland has developed a strong ‘mixed economy’ of employability provision with important contributions made by the private, public and third sectors”,
and, in our consultation response, which was published on 22 March 2016, we said:
“We will work with suppliers to consider what support we can provide to encourage consortia approaches that reflect the existing ‘mixed economy’ in employability services in Scotland of private provision, and local authority and third sector delivery.”
In a debate that we had in the Parliament on employment services on 5 October 2016—I remember that Professor Tomkins was here for that, but he clearly was not listening—I said:
“I intend to take that opportunity to deliver employment support services ... building on our strengths in both the public and private sectors and in local authority, third sector and specialist delivery”.—[Official Report, 5 October 2016; c 30.]
I reiterated that point at our employability summit on 23 November 2016.
In print, in public and in Parliament, I have said that employment services would be delivered across a range of suppliers. That is exactly what we are delivering. The third sector and the supported business sector are a critical element of it as well, and when we take into account all the contracts that we have awarded across the public sector, the third sector and supported businesses, those constitute the majority of the contracts that we have awarded.
I thank the minister for the advance copy of his statement, and I welcome the progress that has been made in developing fair start Scotland. Like the Scottish Government, Labour is committed to a person-centred, tailored, voluntary approach that is based on meeting individuals’ needs.
I have three questions for the minister. First—and this is very specific—can he tell us what percentage of contract value has been awarded to the private sector and what percentage is going solely to the third sector, so that we can establish whether the approach meets the Government’s ambition to have a mixed market of support?
Secondly, will the minister explain why he copied the Tory Government’s approach to the work programme by having a payment-by-results system? The concern is, of course, that providers will focus on early wins and people who are closest to the labour market, leaving those with significant barriers without sufficient support.
Finally, many people will welcome five-year funding, but let me sound a note of caution. What opportunities will there be to refocus the contracts if they do not perform as required?
On the precise percentage of contract value going to the private sector, I will be happy to follow up in writing, but I can tell Jackie Baillie that there is a roughly equal division between the third sector and the private sector and that, when we factor in the public sector and supported businesses, there is a clear majority for the other sectors.
On Ms Baillie’s final point, about opportunities to be flexible, I think that I made clear to the Economy, Jobs and Fair Work Committee that flexibility is important. Ms Baillie will understand that, in the awarding of contracts, there is only so much that we can do. However, there is the possibility to be flexible as circumstances change, for example by looking at the criteria for referral to a programme. That is important, and it speaks to our longer-term agenda of better aligning our various offerings on employability and employment support.
I utterly refute the member’s suggestion that we are copying the Tory model and I will run through the range of ways in which our approach is different from what has gone before and what we expect to happen with the UK Government’s work and health programme. Jackie Baillie said that she shares our ambition to have a voluntary service; our service will be voluntary, which was not the case with the previous programme and will not be the case with work and health. On consistency of service, we have laid out very clearly a minimum expectation of providers; that was not the case with UK Government programmes in the past and is not expected to be the case with the work and health programme—
What about payment by results?
Ms Baillie should not worry. I will come on to payment by outcome. However, it is important that I say on the record why the suggestion that we are replicating the UK Government’s approach is utter nonsense, so let me finish.
With the work and health programme, we see that the UK Government will take the same approach, in that providers will set their own standards, and we see that there will be a reduction in the amount of time for which clients are supported. Under our model, there will be up to two and a half years of support.
We are embedding in our approach an individual placement and support service for people with severe and enduring mental ill health; I recall Bill Scott—
This is a list—
It is indeed a list, so—
In that case, that is probably enough of a list, minister. Can we move on?
If you do not mind, Presiding Officer, I will just finish—
Payment by outcome is indeed part of our model. That is important. However, we are embedding an up-front fee in the model—we heard the call in that regard. Clearly, as with any employment programme, we want the programme to get people into work, so it is important that we set an expectation that it will do so.
I remind members of my role as parliamentary liaison officer to the Cabinet Secretary for Economy, Jobs and Fair Work.
Will the minister say how the Government will align its programme with existing health and social care support? What impact does he expect it to have on other public services?
As I said, integration and alignment of services is critical for this Administration. There will be an opportunity, through the range of providers that we have put in place, to begin work in that regard.
We have already announced a £2.5 million pot of funding for integration and alignment, through which 15 projects, in 13 local authority areas, will better support people with mental health conditions, learning disabilities or housing needs and people who have come out of the justice system.
I recognise inherently the need to support people in all aspects of their life and in their journey towards employment. That is not as simple as focusing purely on employment skills; issues will arise in a person’s life, which is why the integration and alignment agenda is so important to us and why we will take that opportunity through this programme.
I emphasise that the first three questions have taken eight and a half minutes. There are nine more questioners, and I would like to get through them.
The total value of the contracts announced today is £96 million. Will the minister explain what contractual and other assurances are in place to avoid a repeat of the cost and budget overruns that we have seen in many of this Government’s programmes?
I am delighted that Dean Lockhart has got on to the territory of the cost of this service. We have leveraged in additional revenue of £20 million per year from the rest of our budget to make up for the significant cuts that his party’s Government sent to our Administration through the devolution of this service.
The assurances that Dean Lockhart seeks are of course set out as contractual provisions. We will monitor the contracts very carefully indeed, and if any committee of the Parliament ever wants to ask me about any issues, I will happily respond to the committee or raise the matter in the chamber. We have announced the contracts today and the detail of those contracts will be available in the Scottish Parliament information centre, to which I am sure Mr Lockhart will run immediately after this statement finishes.
The Scottish Government is a Scottish living wage employer. In answer to a question of mine, the minister wrote:
“Devolved employment services will support the Scottish Government’s fair work ambitions, in particular by supporting individuals into sustained work which offers a route out of poverty.”—[Written Answers, 14 March 2017; S5W-07108.]
Will fair start Scotland support the Scottish living wage and provide a route out of poverty by paying providers only when they place someone in employment that pays at least the Scottish living wage?
Alison Johnstone is correct to point out the Government’s ambitions for the living wage. Through the award of the contracts, we have taken the opportunity to ensure that providers pay the living wage to those who work for them.
On the agenda of getting people into employment, we will work closely with organisations and encourage them to take every step that they can to ensure that those who end up in employment are remunerated adequately. Our aspiration is for everyone in this country to be paid the real living wage, and our approach to this agenda is no different in that respect from our approach to any other.
I thank the minister for early sight of his statement. In a number of the contract areas, many of the successful bidders and consortium members are organisations that deliver the current service. How will the Scottish Government guarantee that the services that people get will change for the better as a result of the process?
It occurs to me that some of the problems with predecessor programmes occurred when Mr Cole-Hamilton’s party was in government. The fundamental point is that any organisation works to a policy that was set by the Administration that procured the service. I have laid out clearly the fact that our model is very different from the model that went before it, when the service was in the UK Government’s hands, not least in that people will not be compelled to take part—the service will be voluntary. I believe that we will get more out of people in that way.
I assure Mr Cole-Hamilton that there will be a significantly different approach under the contracts, just as there has been during this transitional year. One of my great joys has been in going out to see people who have benefited from the programme that we put in place this year. They have informed me that that programme is drastically different from and far superior to the programmes that they went through when this area was in the hands of the Department for Work and Pensions.
I seek further clarity and information on a matter that has been touched on briefly. What opportunities are there for collaboration with the third sector, in the short term and in the future, in delivering the fair start Scotland support service?
As I have set out, the third sector is an important player in the contracts that I have announced today. In the immediate term, the third sector will be getting on with delivering the contracts. As for other opportunities, I mentioned in my statement the need for continuous improvement. I am looking to establish a group that is similar to the advisory group, which had third sector involvement through the third sector employability forum. I want the third sector to be involved in the new group.
A range of specialist provision has been laid out in the successful contracts and a range of third sector bodies will act as subcontractors. Should contractors require further specialist provision, I am sure that they will prevail on the third sector for that, too.
The minister mentioned that the contracts will be subject to rigorous performance management. Will he go into more detail on the measurement regime? Will he outline how the contracts will be evaluated and how that information will be reported back to Parliament?
As I just said, we will have a group in place to ensure that there is continuous improvement. My officials will rigorously assess the contracts that we have put in place to see how effective they are in reaching the 38,000 people who we want to be supported through the contracts. We are looking closely to ensure that we reach that ambition.
As Parliament would expect, we will regularly publish statistics and make them available for the consumption of members and the wider public to see how we are doing. I am sure that I will return to answer questions on the topic in the future.
Will the minister expand a bit further on the rationale for the nine contract areas and what impact he expects them to have?
We saw and heard a clear concern that the manner in which the previous contracts had been procured did not reflect the geography of Scotland. The previous contracts were too large, which precluded a number of organisations from bidding.
We have worked with a range of people and organisations, including local government, that are involved in delivering a range of employability interventions. For example, the Scottish local authorities economic development group had a preference for eight contract areas. We looked at its proposition, which we thought was more or less right, but we considered that nine contract areas would better reflect what is required, given the need to deliver to local circumstances.
We are looking at the contracts closely. When the contracts come to their end, depending on the direction that we want to take, we will look closely at how effective our approach has been.
The minister suggested that detailed outcomes data will be publicly available from all providers to ensure the effectiveness of each regional contract. At what stages will the data be provided?
I cannot say today what those stages will be. I made clear my commitment that we will publish that information regularly and make it readily available. As soon as it is confirmed when we will make the information available, we will let every member of the Scottish Parliament know. If Mr Halcro Johnston—or anyone else—has further questions about that, I will be happy to respond.
Will the minister say something about those who are receiving employment support and who might be a bit concerned about how the transition will work?
That question is important, because we do not want anyone to be concerned. Let me be clear to Mr Mason, the rest of the members in the chamber and, indeed, the wider public, that those who are benefiting from support will continue to receive support from the providers that we have put in place to cover the transitional period until the end of this financial year, following which our new contracts will be in place. That will ensure clear and consistent provision so, in that sense, no one needs to worry.
Can the minister offer insight into how adequate provision was made for local specialised services to participate meaningfully in the procurement process in their own right?
That issue was critical for me in allowing a wider range of suppliers. There has been significant engagement over a long period—it started several years ago—to get to the position that we are in. We have engaged through a number of public events and through the Scottish Government’s website to make people aware of the opportunity to participate in the procurement process. Through that engagement, the third sector employability forum expressed concern about the length of time that we had allowed for people to tender. Having heard that concern, we extended the period in which people could tender for the service.
I have been responsive to that concern. We did all that we could to ensure that specialist providers in local areas could take part in the procurement process. That is partly why we put in place nine contract package areas. My clear view is that, if we were under the work and health programme, which is administered by the DWP, it is very likely that Scotland would now be one contract package area. That would have given local organisations virtually no chance whatever of being able to tender.
Will the minister confirm that those with a greater need, who have not been supported by the previous DWP approach, will be at the forefront of fair start Scotland?
I can confirm that. We are operating a model whereby three levels of intensivity of support will be available, depending on what the individual requires. I made the point that up to 30 months of support will be provided. That includes 18 months of pre-work support and up to 12 months of in-work support, which is a significant advance on what was in place before and on what we expect in the work and health programme.
I am alive to the concern that those who need support most must have it, and that is what we are putting in place in our programme.
I thank the minister and members.
The next item of business will be a debate on motion S5M-07946, in the name of Gordon Lindhurst, on the gender pay gap.
Gender Pay Gap
I call Gordon Lindhurst to speak to and move motion S5M-07946 on behalf of the Economy, Jobs and Fair Work Committee.15:13
Last spring, the Economy, Jobs and Fair Work Committee undertook an inquiry into the economic impact of the gender pay gap in Scotland. We heard from a large range of witnesses, and I thank everyone who gave us their views during the inquiry. Whether they did so in written evidence, in Twitter stories, in case studies, at formal meetings or during committee visits, all their views helped to inform our inquiry and shape the report.
This might sound slightly controversial, but we were well aware that we were by no means the first to attempt to tackle the subject of the gender pay gap. However, we wanted to look at the issue from an economic point of view and to understand the potential benefits to Scotland’s economy if there were parity of earnings.
It is important to attempt to clarify what we mean by the gender pay gap. As has been highlighted, a common misconception is that it is about men and women being paid the same for equal work. The gender pay gap is not the same as equal pay. The Equal Pay Act 1970 introduced as a legal right the requirement that women should be paid equally for doing the same or comparable work. It was, therefore, a disappointment to the committee to hear that, despite more than 40 years having passed, the issue has still not been resolved and live claims remain outstanding against employers who are considered to discriminate on grounds of gender.
If the gender pay gap is not defined in the same way as equal pay, what is it? How is it measured? The committee found that calculating the pay gap is not a straightforward task. Most commonly, it is carried out by comparison of the hourly earnings of men and women; however, unlike for other labour market indicators, such as unemployment, there is no internationally recognised definition of the pay gap. That means that, in Scotland, the pay gap figure can vary from 6 per cent to 33 per cent, depending on which measure is used. That made it difficult to draw comparisons between Scotland and other countries.
To be consistent with the United Kingdom Office for National Statistics, the Scottish Government uses the full-time median pay gap, which compares median hourly earnings of full-time male and full-time female workers. However, the Scottish Government’s measure excludes part-time workers, and in doing so it excludes 42 per cent of female workers in Scotland. Seventy-five per cent of part-time workers are women, with 42 per cent of women working part time compared with 13 per cent of men. If part-time workers are not included in the calculation of the gender pay gap, it is to be questioned whether the result of the measure that is used by the Scottish Government fairly represents the Scottish workforce. Accordingly, the committee has urged the Scottish Government to change the way in which it measures and reports the gender pay gap in its national performance framework to take account of part-time workers. As a result, the Scottish Government has at least committed to include additional information on the Scotland performs website to show the position for part-time workers, which is to be welcomed.
Rather than look just at the gender pay gap, the committee wanted to look at the possible implications for the Scottish economy. We heard evidence from a range of witnesses, who spoke to the potential economic benefit of increasing women’s participation by reducing the gender pay gap. Further Scotland-specific and detailed research needs to be carried out, but we know that women across our economy continue to be concentrated in low-paid industries and part-time work. They can be impacted at all stages of their working lives and not solely as a result of choosing to start a family or to take time out of their careers.
It is particularly important to note the care sector and its importance in our society. It is the committee’s view that the care sector—including childcare and adult and elderly care—is an undervalued but growing and central part of Scotland’s economy. It is not just about childcare. Care as a sector is also representative of many of the reasons for the existence of the gender pay gap. The sector is dominated by women and is traditionally low paid. Social care needs a more diverse workforce and to be valued as a sector. It also needs to be better paid.
In its recommendations, the committee recognised the impact that improving pay in child, adult and elderly care would have not only on reducing the gender pay gap but on recruiting a more balanced workforce. That balance, we heard, can have a real and meaningful impact.
During the course of the inquiry, members of the committee had the pleasure of visiting numerous businesses, and the experiences that were gained from those visits are reflected in the report and its recommendations. I will give just a few examples. Some members visited Home Sweet Home, a domestic cleaning agency that works with self-employed cleaners and whose workforce is 95 per cent female. The agency recommends payment of the living wage as a minimum, but the 5 per cent of its workers who are male often undertake the higher-paid jobs.
One of the other visits was to Men in Childcare, a Scottish Government and City of Edinburgh Council-funded initiative that is aimed at encouraging men into childcare, because childcare is a sector that is primarily peopled by female workers. On that visit, we heard men speaking positively about the reception that they had experienced from the families of the children with whom they worked, and they highlighted the need for more men to show an interest in the profession. Encouraging men into childcare and supporting both men and women with wages that show the importance of care could have real benefits beyond the purely economic.
I also highlight the importance of flexible, agile and part-time working. The committee found that, even if employers are actively looking to assist women in re-entering the workforce, they might struggle with the provision of part-time jobs and flexible working. The committee heard that, in the UK, around 8 per cent of roles that are advertised with a salary of more than £20,000 per annum offer some sort of flexible working and that flexible working can be important for different reasons and at different career stages. Without the opportunity of flexible working, women can lose out in the jobs market and all of us can lose out on what might have been provided by their skills. The committee has heard evidence of the business benefits of offering agile and flexible working, and it notes that good practice among companies can positively influence appropriately timed maternity return rates.
In recent years, some companies have introduced programmes to encourage people back into the workforce after a career break. That might be a return to work after maternity leave for some, although it is not exclusively that. The committee has heard that one of the key points at which women drop out of the workforce is after a career break, often to care for children, and we were encouraged to hear that businesses and organisations have been finding innovative ways of supporting employees to return to the workforce and retrain with the assistance of appropriate mentoring. The Scottish Government’s support for returners programmes and its commitment to learn from best practice and work with partner projects are to be welcomed. The committee recognises that different solutions are needed for different sectors and that returners programmes should be tailored accordingly.
There are a host of arguments as to why the gender pay gap should be addressed. In this short speech, I have had the chance to cover only a few of the key points and a few aspects of the committee’s report although the subject is complex and wide ranging. For example, the Equality and Human Rights Commission’s written evidence on its own gender pay gap situation, as independently audited, revealed a 0 per cent pay gap across its staff groups, although pay equality varied at different levels in the organisation.
There is, therefore, work to be done, which is why in its report the committee recommends that the Scottish Government produce an overarching strategy to address the gender pay gap, including an action plan and measurable targets. I note that the Scottish Government will undertake a scoping exercise to see whether a co-ordinated cross-Government action plan is feasible. The whole committee is, no doubt, looking forward to the result of that.
With the political will, we can move forward in a balanced and appropriate manner to address the issue. It is a matter of fairness to all.
That the Parliament notes the conclusions and recommendations contained in the Economy, Jobs and Fair Work Committee’s 6th Report, 2017 (Session 5), No Small Change: The Economic Potential of Closing the Gender Pay Gap (SP paper 179).15:23
I am grateful to the members of the Economy, Jobs and Fair Work Committee for the report that we are debating today and, indeed, the chance to debate it, and I welcome the work that they have undertaken to build a better understanding of the drivers and reasons for the prevalence of the gender pay gap in Scotland.
The written submissions received by the committee and the evidence sessions that it had all underline the complexity of this issue. However, this Government does not shy away from issues that are complex, and we are determined to reduce gender inequality and improve the position of women not only in the workplace but in all aspects of Scottish life. Our recently launched programme for government sets out our plan to shape the kind of Scotland we all seek: an inclusive, fair, prosperous, innovative country, ready and willing to embrace the future.
Our strong commitment to equality lies at the core of Scotland’s economic strategy, and closing the gender pay gap is a priority in promoting equality and, just as fundamentally, boosting inclusive economic growth.
Scotland is making positive progress. The overall pay gap in Scotland, which reflects all workers, full and part time, stands at 15.6 per cent, which is down from 20.4 per cent in 2007. In 2016, the full-time pay gap was 6.2 per cent, which was lower than the UK figure of 9.4 per cent and down from 11.9 per cent in 2007. The figure is too high and we must do more, but there is progress.
That allows me to mention Gordon Lindhurst’s point about measurement. He is right to reflect that there is no single international standard. We have responded to the committee’s request, and we will publish, through Scotland performs, a wider range of information on the nature of the gender pay gap, using a range of measurements. The fundamental thing is that, no matter the measurement, we want the figures to move in a positive direction, and that has happened in Scotland, although of course we want the gap to reduce further still.
The evidence that was provided during the inquiry has reinforced much of what we know about the main drivers of the gender pay gap and confirmed that there is no single solution to closing it. We agree with the committee that high-quality evidence and analysis are vital to underpinning effective and inclusive policy making in Scotland. We are therefore taking real steps forward in improving our gathering and communication of data. Just last week, we published a working paper on the development of a gender index for Scotland. We will now engage in meaningful dialogue with those who have an interest in the matter as we take that work to its conclusion. We plan to hold a workshop later this autumn to discuss how to take that forward alongside work on other data gaps that were highlighted in the recently published “Scotland’s Equality Evidence Strategy 2017-2021”.
We must use the data, as we seek to improve it, and what we already know about underrepresentation of women in traditional male-dominated careers to guide our approach. For example, we know that women are still underrepresented in science, technology, engineering and mathematics careers and that, even in sectors where women are well represented, such as finance and law, occupational segregation prevents women from progressing to senior management positions. In that regard, I agree with Gordon Lindhurst that, equally, we need to take steps to diversify the workforce in the care sector. We need more men to enter that sector and we must ensure that those who work in it are adequately remunerated. That is why we have committed to ensuring that those who work in adult social care and early years childcare are paid the living wage.
Segregation in the workplace, gender stereotyping and discrimination start at an early age. Incidentally, that is one reason why it is so important for us to ensure that more men work in early years childcare—it is so that young boys have role models that they can look to and understand that childcare is just as much a career for them as it is for their female counterparts. It is also why we have been developing our STEM strategy, which we will publish shortly, and why we are implementing the developing the young workforce strategy. In partnership with Skills Development Scotland and the Scottish Further and Higher Education Funding Council, we have set targets to increase the gender minority share in the most imbalanced college subject groups and modern apprenticeship frameworks by 2021.
When I am out and about, I often see that a modern apprenticeship can be a life-changing opportunity for a young person. That is why we are committed to expanding the reach of such opportunities to tackle gender imbalances and promote equality of access. Through the work on developing the young workforce, the modern apprenticeship equality action plan and the Scottish funding council gender action plan, we have set out a number of ways in which we aim to ensure that young people are supported with their subject and career choices.
Since my appearance before the committee, Skills Development Scotland has published its “Equality action plan—Year 1 update: For Modern Apprenticeships in Scotland”. Overall, there have been improvements in the number of modern apprenticeship frameworks where the gender balance is greater than 75:25, with the figure falling from 74 per cent in 2015-16 to 70 per cent in 2016-17. That is welcome progress, although of course again we must see more.
Skills Development Scotland continues to work with a range of organisations to further improve the gender balance in the uptake of apprenticeship frameworks and we will continue to support them to ensure that apprenticeship opportunities are open to all.
There is a clear need to make sustainable change to societal and cultural norms to achieve the inclusive growth that we want to see. That is a long-term commitment, not one that we will achieve overnight. We need consistent commitment from every part of the system to make a lasting change and to make sure that we tackle discrimination in the workplace.
The Government is committed to that agenda, which is why I chair a working group on pregnancy and maternity discrimination and why we support a women returners programme, which Gordon Lindhurst mentioned. It is why we have worked with Timewise Solutions and we fund and take part in the family friendly working Scotland partnership. It is why we have the Scottish business pledge and why we are rolling out more early years childcare. We are very much signed up to the agenda.
It is not just a commitment that all of us in the political sector need to make. There needs to be a societal commitment. However, the chamber and the committee can be assured that the Government is signed up to the agenda.15:30
I thank the clerks and others involved for their hard work in preparing the report on the gender pay gap. It is an important report, which deals with a complex topic that cuts across fairness, equality and social justice as well as wider economic considerations such as women’s low pay and skills development.
The gender pay gap is not unique to the UK, but is a common feature in advanced and developing economies worldwide. As the minister said, the gender pay gap in Scotland stands at 6.2 per cent for full-time employees and 15.6 per cent for all employees, and it is at the lower end of the scale compared with the gap in many European countries. However, more needs to be done to close it.
With that objective in mind, a major focus of the committee was to identify the underlying factors that cause the gap in pay. The committee looked in depth at a number of those factors, including occupational segregation—in particular, the underrepresentation of women in STEM and other highly paid occupations. For example, only 2 per cent of engineering jobs and 18 per cent of digital technology jobs are carried out by women. The opposite is true in lower-paid sectors, where there is an overconcentration of female workers. For example, Scottish Care told the committee in evidence that 86 per cent of workers in the care sector are women.
Other factors that we heard about in evidence included the low levels of women who reach senior management positions in organisations and women not returning to work after having children or not returning to the same level. EY told us:
“Working below skills level is an issue for women when they want to return to the workplace—and the older a woman gets, the harder that is.”—[Official Report, Economy, Jobs and Fair Work Committee, 14 March 2017; c 44.]
In order to effectively address the gender pay gap, it is important that we look beyond the headlines and the easy solutions, and address the underlying issues. That is what the committee has done by setting out a comprehensive set of recommendations. Time allows me to highlight only a few.
We need to tackle the long-term factors that result in occupational segregation. The committee heard extensive evidence that the key to tackling occupational segregation is encouraging more young women to enter high-earning fields, such as STEM. Specific recommendations to address occupational segregation included improved career guidance from primary school right through to tertiary education—there was a feeling that sometimes careers guidance is out of date with the opportunities in the workforce and sometimes it comes to pupils too late. There was an emphasis on maximising the uptake of women workers in STEM areas. Another recommendation was the need to address the gender imbalance in modern apprenticeships—we welcome the plans for that that the minister announced. There is also a job to be done in encouraging men to enter social care and other sectors in which female workers are heavily represented.
The committee also recommended better support for women returning to work. That is being addressed to some extent by Government initiatives. The UK Government has announced a £5 million fund to support women returning to work and the Scottish Government is providing support as well. It is incumbent on the private sector to establish a returner programme for women. The committee heard powerful evidence that the valuable knowledge and skills of experienced women are not being fully deployed when they return to work. We simply cannot afford to lose that valuable talent from the workplace.
We need to consider the impact of the decline of female participation at colleges and the impact that that has had on supporting women back to the workplace. Audit Scotland reported:
“The fall in part-time places ... has had a disproportionate effect on female students.”
The committee further recommended that the care sector, as Gordon Lindhurst mentioned, should become a Scottish Government priority sector, acknowledging the importance of the sector to Scotland’s economy and the increased spending that has taken place, and will take place, in the sector. Changing demographics will mean that demands placed on the care sector will increase significantly, and it is important that we prioritise that to achieve a balanced workforce, improve productivity and help to make the sector fit for the challenges that lie ahead.
The committee called for more analysis and information on the gender pay gap in Scotland—again, that was touched on by the minister. We welcome working together with the Government in that area, because the gender pay gap varies according to a number of factors such as age, social class and level of education; it is not a static one-dimensional problem. The committee recommended that the Scottish Government should do more work in that area to analyse how we can address the gap. In that regard, the committee welcomed the UK Government’s initiative for companies to report on their gender pay gap. Concern was expressed that the 250-employee threshold for reporting might not capture large parts of the small and medium-sized enterprise economy in Scotland, but the Confederation of British Industry said:
“Any extension of mandatory reporting to companies in Scotland with less than 250 employees would place a significant regulatory burden”
on those companies.
The Scottish Conservatives support steps to close the gender pay gap in Scotland. We agree with the committee’s approach to dealing with the underlying issues and not just the headlines or outcomes. As the report concludes, there is recognition that
“the reasons for the gender pay gap are deep-seated and wide-ranging and need to be tackled”
“a number of policy areas, including education, skills, childcare, procurement”
We agree, and we look forward to working with the Scottish Government to close the gap.
I call Jackie Baillie. You have up to six minutes, Ms Baillie.15:36
Presiding Officer, things have certainly changed since you and I were first elected to the Parliament in 1999. I am delighted that I have been preceded by three men in this debate on the gender pay gap—the feminisation of debates in this Parliament continues apace.
I am very proud that the Labour Party and Barbara Castle introduced the Equal Pay Act in 1970, so that men and women would receive equal pay for performing equal work. That, of course, followed on from the Ford sewing machinists’ strike at Dagenham and fundamentally changed women’s industrial history. We have come a long way in almost 50 years, but there is much more work to do.
Let us not, as the committee convener quite rightly pointed out, confuse equal pay with the gender pay gap. The gender pay gap in Scotland today, which stands at almost 16 per cent, is caused by a myriad of different, complex and interconnected issues that, when taken together, underline women’s inequality in the labour market.
Women are still more likely to be in low-paid, part-time, low-skilled jobs. Women are underrepresented in senior management and leadership roles. Women still have the majority of care duties, whether that is for children or older people. If we maintain the snail’s pace of change that we have now, it will take another 140 years to close the pay gap. I am sorry, but I cannot wait that long—I will not live that long, for a start. However, I am impatient for change, not just for my generation, but for my daughter’s generation and the women who will follow her.
I am impatient for that change for our economy, too. The GDP figures that were announced today show that our economy grew in the last quarter, but by only 0.1 per cent. As night follows day, out came the press release from Keith Brown claiming credit for the good news. The Scottish economy is teetering on the brink of a recession and the response of the Cabinet Secretary for Economy, Jobs and Fair Work is breathtaking in its complacency. It matters now more than ever before, because lower growth rates between Scottish and UK Governments will have an impact on our block grant because of the fiscal framework. Growing our economy is a fiscal imperative.
Notwithstanding a long-standing Green critique of economic growth as an overriding objective, does Jackie Baillie acknowledge that a narrow focus on GDP fails to understand the different gendered aspects to economic work? Unpaid caring work, for example, does nothing for GDP—a great deal of such work is done by women—whereas paid caring work is seen as contributing to GDP. It is a myopic analysis.
As the member will appreciate, GDP can be compared across different countries. However, I accept his point that there should be more quality in the statistical collections that we make to indicate what the gender pay gap is across the board.
We know that growth suffers if there is a continuing pay gap. Over the course of a woman’s working life, she will earn on average £456,518 less than a man. That is a shocking statistic. What a lost opportunity. If we close the gender pay gap, we inject a staggering £17 billion into the Scottish economy. That is transformational for our economy and for women. It is imperative that we close the gap.
The committee came up with a range of recommendations, covering everything from a national strategy, flexible working and tackling occupational segregation to making care a priority growth sector. I say as gently as I can to the minister that the Government’s response is weak and timid. Where is the evidence of urgency and momentum? Where is the evidence of political priority? I hope that the minister proves me wrong; here is one area in which he can do just that.
Formally designating care as a key growth sector would be a small but welcome first step in addressing the undervaluation of care work. We know that the majority of staff in the care sector are female. The jobs are often part time and low paid. As a society we understand the importance of care, and yet take-home pay shows that we do not value those who choose caring as a profession. At the moment, care is the single biggest growth sector in employment terms, yet it is not on the radar of our enterprise agencies. That needs to end.
We know that childcare provision can be a real driver for economic growth, because it enables parents to return to the workforce or increase their hours. With the expansion of childcare, adult social care and older people’s care, we need to address the skill shortages and help the private and third sector in the fields of investment, leadership, innovation and fair work. That is a job for our enterprise agencies.
Our economic strategy moved towards a more inclusive definition of what is important to the Scottish economy. The care sector should be at the centre of that, and should be supported by all that is best in our enterprise support structures.
I recognise that a first step has been taken by paying the real living wage to adult social care staff, but that does not apply overnight and it does not apply to childcare staff. When health and social care partnerships are commissioning services, there are still issues for private and third sector care staff as costs are driven downwards. There is much still to do to value all of the workforce well, and to shatter the glass ceiling for women.
A Labour Government would focus on reducing the gender pay gap, not on protecting the privileged few. We would increase the minimum wage to a real living wage of £10 per hour and, as part of our plan for rights at work, we would ensure that companies complied with gender equality legislation.
The prize is great for women and for our economy.15:43
I will begin my speech with one of many workplace discrimination stories that I have heard from my female friends over the years.
One woman was a middle manager in an information technology services firm. She had worked for the same firm for 12 years, working her way up to managing the most prestigious account that the team had. When she told her boss that she was pregnant, she was immediately removed from that account and told that she would have to spend the rest of her time before she went on maternity leave training up her male replacement.
When she returned from maternity leave, she was not given her account back. She was put on to a number of small accounts, all of which were on—to use the company’s terminology—red alert status because of previous mismanagement by another staff member. On her return from maternity leave, she was effectively set up for failure. That example is from only a few years ago and is part of a series of entrenched behaviours and attitudes that cause the gender pay gap.
I started work in London in the mid-1990s and, although it seems as though we have moved on in some areas, it seems as though, in others, we have not moved on as quickly as I would have liked. In my first job as a systems integrator, I appeared in a league table that was pinned to the breakroom wall. Best work performance? No, sadly not. It was a ranking of the sexual attractiveness of all the junior female employees.
In taking evidence for the report, my colleagues on the Economy, Jobs and Fair Work Committee and I heard detailed testimony about the ways in which women are still put on an unequal footing in the workplace. The motherhood penalty is one example. According to a PricewaterhouseCoopers report, three in five professional mothers who return to the workforce are likely to be moved into lower-skilled or lower-paid roles, with total earnings being reduced by a third. That phenomenon sees a disproportionate number of women taking on part-time jobs and forgoing professional advancement.
The gender pay gap is the undeniable embodiment of a workplace culture in which women are systematically undervalued and unduly limited. Those limitations must be dismantled if the gender pay gap is to truly be reversed, and the Economy, Jobs and Fair Work Committee’s report sets forth a number of recommendations that aim to do just that.
The committee heard that the motherhood penalty would diminish if changes were made to flexible working and childcare provision. A demand for flexible jobs that outstrips supply is causing a talent bottleneck that has had an adverse effect on working mothers, forcing them into part-time jobs that they are overqualified for and do not necessarily want. Flexible working enables people to, for example, tend to caring responsibilities without sacrificing their earning potential and professional advancement in the process. That has business benefits as well, as flexible working has been shown to boost labour market participation and productivity. The committee heard that the UK has a 1.5 breadwinner model. I would like us to move away from that.
I have spoken a lot about motherhood and how that links into the gender pay gap but, of course, this is an issue that affects women with and without children. As the committee report notes, little progress has been made on easing occupational segregation in areas such as modern apprenticeships—female starts in engineering, construction and automotive apprenticeships in 2015-16 did not rise higher than 6 per cent. Colleges Scotland stated that it believes that that has less to do with the apprenticeships and more to do with societal attitudes. That is why there must be interventions early on in a child’s life to prevent the gendering of occupations. The work of SSE is a great example of that, as it has created its own picture book for children that features a female engineer, and the book is brought into schools by female engineers who then speak about their work.
Engender testified before the committee that there is a “leaky pipeline” of women and girls in the hard sciences. Strategies must be put in place to foster greater and more sustained female involvement in those currently male-dominated fields. The City of Glasgow College’s women in construction and women into engineering courses are good examples of what can be done in that area.
Occupational segregation persists outside the hard sciences as well, with women holding 50 per cent of positions in finance but those jobs being concentrated at the lowest-paying end. Similarly, there are more women than men in the law sector but only 28 per cent of partners are female. Further, if women break into the technology sector—which was the sector that my earlier example from my own life concerned—or the engineering or construction sectors, there is a double glass-ceiling effect that means that only 12 per cent of females rise to management roles in those fields.
I can see that I am running out of time, so I will end by saying that the report’s foreword says that, at the present rate of progress, it will take us 140 years to close the gender pay gap. I think that everyone in the chamber would agree that that is not acceptable, and I look forward to the Government taking action on some of the report’s recommendations.
Any extra time that members take will affect their colleagues later on.15:50
I begin by adding my thanks to those already given to the committee and all those who contributed to this report on the gender pay gap.
This is a very worthwhile, substantive and wide-ranging piece of work. I have no doubt that, given the clear cross-party support for a number of the recommendations, the work of the committee will ensure that Scotland continues to be a leader in this area.
Be in no doubt that we must make sure that that happens. This issue is so vital and important; it goes right to the fundamental questions of fairness, equality and the kind of society in which we want to live. If we cannot address it and ensure that everyone, regardless of gender, has the same opportunities throughout their lives, we should all be embarrassed, not just as a Parliament but as a country.
That said, and despite some of the worrying and disappointing evidence of continued challenges that the committee heard in the course of its evidence taking, we have to recognise and learn from the very significant steps that have already been taken. In doing so we must pay tribute to the instigators and trailblazers who, through the generations and across the decades—and for that matter over the centuries—have, through their personal commitment, delivered real progress and changed hearts and minds.
As I have said many times in this chamber in other debates, we have to be willing to view issues around gender inequality, such as the gender pay gap, within the context of society as a whole and to recognise particularly, as other members have referenced, further issues around the representation of women at the highest levels of decision making.
That is why I am particularly delighted that, for the first time in the UK, we see the roles of head of state, head of Government and head of the judiciary all held by women. Lest we forget, here in the Scottish Parliament we also have the first female First Minister in Nicola Sturgeon and, until recently, all three leaders of Scotland’s main parties, or—in the interest of the cross-party spirit of this debate—three out of the five party leaders in this Parliament, were women. I recognise Jackie Baillie’s continued perseverance on this cause and I am, of course, disappointed that she did not put herself forward to ensure that that situation could continue.
I believe that those examples, and indeed the examples of all women in public life and in prominent positions, send out a strong message about the changes that are already taking place in our society.
Although we cannot ignore that progress, neither it is an excuse to rest on our laurels. As other members have addressed in this debate, it is not all about equal pay. As I have alluded to, it is also about ensuring that all opportunities, options and choices are open to all, so that men and women can compete on a level playing field and go to the very top in our society. Ultimately, that is the only way to address the discrepancy in average pay.
It is also about addressing continued stereotypes and the often underlying, self-limiting factors that discourage women from entering STEM-related jobs. Equally it means that a number of men, for various reasons, decide that they do not wish to be involved in the care sector or are unwilling to go into primary teaching or nursing.
Again, although I understand that progress has been made in some of those areas and appreciate that, relatively speaking, such barriers are beginning to break down, to find ourselves in 2017 still having such fundamental challenges in our workforce is somewhat alarming. There is clear evidence of long-term occupational segregation, and the committee’s report captures some of it.
I have found, particularly from the many discussions that I have had with teachers over the past year and a half, that within our schools far too many young people are taking decisions too early in their school career and learning journey. The decisions that they make early on then continue to influence their thinking throughout the rest of their lives.
For that reason, and because of the multitude of challenges that exist, making the progress that we all want to see is so tricky. There is no single answer, but thanks to the work of the Economy, Jobs and Fair Work Committee and what I believe is a genuine willingness on all sides, I believe that we can continue to make significant progress. We must do so because every day that the gender pay gap continues to exist is another day when our economy is underperforming. More important, the underutilisation of skills and talents in our society and country is a crying shame at both the individual and national level.15:55
I refer members to my register of interests.
Before my election to Parliament, I had the singular privilege of working for nearly 20 years as a trades union organiser for the GMB across Scotland, negotiating pay rises, averting redundancies, battling grave injustices such as the construction industry blacklisting scandal and securing equal pay for women workers, more often than not low-paid women workers—in supermarkets, in social care in our communities and in factories and offices, in cleaning, catering, caring, clerical and cashiering work.
My first recourse to an employment tribunal all those years ago was with an equal pay case for the head chef at Rosyth dockyard, who discovered that she was getting almost £2 an hour less than her predecessor. We won. Down the years, I have led and won equal pay cases for cleaners at Longannet power station and at Diageo sites across Scotland, where we discovered that there was a janitors’ rate of pay—male; a cleaners’ rate of pay—female; and a part-time cleaners’ rate of pay—female too.
As the committee report shows, women make up 76 per cent of all part-time workers in Scotland, so they are among the lowest hourly, weekly, monthly and annually paid workers; and 20 per cent of all women workers—nearly 300,000 women in Scotland today—earn less than the living wage of £8.45 an hour, compared with 14 per cent of male workers. To tackle low pay and in-work poverty is also to tackle the gender pay gap, which is why, for the Labour Party, the living wage is a political priority.
It has always been clear to me that work predominantly performed by women is markedly undervalued and underpaid. The committee was vividly told by one witness that
“if the social care workforce in Scotland was more balanced and representative of the community and—dare I say it—more male dominated ... we would not be a low-paid profession.”—[Official Report, Economy, Jobs and Fair Work Committee, 18 April 2017; c 42.]
I say to the Government that unless we re-evaluate those jobs in our society and in our economy and address the scourge of low pay, we will never close the gender pay gap.
There is something else that I knew from the outset of my time as a union organiser: that through their trade unions, working people could achieve much through industrial struggle and, occasionally, could achieve much through the courts and tribunals, but that a real and decisive advance is often made through political action and decisions.
I spent much of my time in the union going toe to toe with some of Scotland’s biggest employers, challenging them to pay the living wage. One of the best examples is Diageo, the biggest drinks company in the world. Despite negotiation after negotiation, year after year and record profit after record profit, Diageo would not move on the living wage for its lowest-paid workers, who are employed for it but not by it. Transferred every few years from Compass to Mitie to Sodexo, those lowest-paid cleaning and catering workers—again, a group of predominantly women workers—were treated for too long as second-class citizens. So, when a representative of Sodexo and a representative of Diageo appeared before the committee as part of our inquiry into the gender pay gap, I was not surprised to hear them describe how they are committed to the living wage concept.
The committee therefore decided that we should highlight in our report the difference between actual living wage employers and those conceptual living wage employers. It is there in paragraph 192 of the final report:
“‘actual’ living wage employers ... ensure all those working for the business are paid the living wage, and ‘conceptual’ living wage employers ... support the concept of the living wage but do not actually implement it.”
I am delighted to report to Parliament this afternoon that those low-paid workers employed by Sodexo on the Diageo contract on sites across Scotland—those workers who I represented for all those years—now have it confirmed in writing that, by the end of this year, because of political pressure applied in this Parliament, they will get the living wage of £8.45 an hour.
There is a lot that we can do in this Parliament. We can devise a national strategy, we can act through public procurement, we can redesign the Scottish business pledge and we can prioritise the social care sector, because we do have it in our power to tackle the gender pay gap. If we are serious about equality and the place of women in society, this Parliament and this Government must act, not only as a matter of economic imperative but as a matter of moral imperative, too.16:01
I am grateful for the opportunity to speak. I am pleased that the Economy, Jobs and Fair Work Committee chose to devote significant time to an inquiry into the gender pay gap, and I thank it for its work.
I begin by reflecting on a problem that I think our society has in discussing the issue. The problem is that a great deal of our focus and attention is drawn to the top end of the economic inequality in our society. Very often, when the gender pay gap is even acknowledged in mainstream media discussions, the focus is the highest-flying businesspeople or, as we saw recently, the massive salaries that are given to television stars—the six and even seven-figure salaries that a tiny proportion of people in our society enjoy.
Obviously, I want the BBC and other big broadcasters to address gender inequality, and if it means that we see a bit less of Andrew Neil on the telly as well, that will just be the icing on the cake. However, the drawing of our attention only to the tiny number of people at the top end of our society’s economic inequality fails to address the reality of the vast majority of people’s lives.
That came across in something that Oliver Mundell said. He said that more women getting to the top—the very top, I think he said—is the only way to address the gender pay gap, and as an example he mentioned that the heads of Government, state and the judiciary in the UK are all now women. If getting women to the very top was the best way of addressing the gap, we would be there already, but we are not there. That example demonstrates that a focus on the very top is not enough to address the wider problem.
I understand the point that Patrick Harvie is trying to make, but I think that it is a mischaracterisation of my remarks. I said that women being in those prominent roles and being seen to make decisions and take the lead in our public life sends out an important message, and probably the strongest message of all. I did not say that it is the only thing that can be done. I hope that Patrick Harvie will accept that that is the point that I was making.
If that is what Oliver Mundell intended to say, I am happy to accept that, but I suggest that, although sending out that signal may be a nice thing to do and may even have some real value, if we send out a signal that all is right at the top without fundamentally changing the structural inequalities that exist throughout the rest of our society and our economy, we will not achieve anything more than a cosmetic change.
A number of members have touched on the economic case for reducing and eliminating the gender pay gap, and that case comes across strongly in the report. In fact, I wonder whether it comes across too strongly in the report, because although there is undoubtedly a strong economic case for reducing the gender pay gap—as has been demonstrated time and time again by numerous studies; this is not news, but something that we know to be the case—is it really the one argument that we should be relying on more than any other?
Surely we can agree that gender inequality is wrong in principle, and that the gender pay gap is one expression of gender inequality in our society. If a business feels that it is not able to improve its economic performance by reducing the gender pay gap, it should not make that a justification for not taking action. We should be clear about the economic opportunities that arise from reducing and eliminating the gender pay gap, but we should not rely solely on that economic argument—or even, perhaps, give it prominence—to do something that is the right thing in principle.
The gender pay gap is a symptom of wider societal structural inequalities, which also matter and require to be addressed. Richard Leonard touched on that when he talked about the way that we value different kinds of work. The kind of work that, historically, has been done by a higher proportion of women than men has been, and still is, undervalued. However, is it enough simply to get more women into high-value careers in the STEM industries, for example, although that is great and a good thing in its own right? Is it enough to get more men to think about a career in the caring professions if those caring professions, which are critically important to our quality of life, are still undervalued and paid less than they ought to be if we want to close the gap?
Do the services that we have genuinely meet the diverse needs of all women, including single parents, 92 per cent of whom are women, and women who are returning from career breaks? As we have heard, women who are returning from career breaks are not necessarily looking for help into the easiest and quickest entry-level job; they are looking to regain and return to a meaningful career that they may have left, but only for a period of time. We should be giving them the support that they need as well.
Finally, I make the case that the Government’s commitment to explore and fund trials of a citizens income is a critically important way to address those wider structural gender inequalities that feed through into the pay gap. It will ensure that all people—women and men—are better able to strike their own balance between learning, working, volunteering, caring and all the other things that matter in our lives.16:07
I thank Gordon Lindhurst and the Economy, Jobs and Fair Work Committee for bringing this important motion and report to Parliament. I congratulate the committee and its convener on the work that they have undertaken.
Like other speakers in the debate, I find it dispiriting that after 18 years of devolution and a range of debates, we must still hold such inquiries and look to close the gap between male and female median earnings that the committee conservatively estimates to stand at 16 per cent.
That frustration was mirrored by several prominent female broadcasters in their open letter to the director general of the BBC, Lord Hall, earlier this summer. They said:
“You have said that you will ‘sort’ the gender pay gap by 2020, but the BBC has known about the pay disparity for years. We all want to go on the record to call upon you to act now.”
This Parliament has known about that disparity for the entirety of its existence. It is now time for us to act.
The committee pointed out that the extent of the gender pay gap is hard to calibrate, and its causes are difficult to fathom accurately, particularly given the current 250-employee minimum threshold for gender pay reporting. The committee rightly recommends that the Government should adopt a range of indicators to establish patterns, trends and hidden obstacles to female pay progression in this country.
Nevertheless, the committee has given us a flavour of the challenge before us. Women continue to be concentrated in low-paid industries and part-time work. For example, in Scotland last year, 40 per cent of women were in part-time work, and they made up 78 per cent of all part-time workers. Male entrepreneurs in the self-employed workforce appear to find greater ease in accessing capital than their female counterparts.
Our response to gender inequality in the workplace cannot rest solely on the calibration of pay scales. Since the exchange of human labour began, systemic barriers have existed that have created an imbalance in the opportunities and advantages that women can enjoy at work. We must therefore take a whole-systems approach to reform.
When he was Deputy Prime Minister, my friend and then colleague Nick Clegg sought to change the narrative around gender stereotypes at work through shared parental leave. He identified maternity—and even just potential maternity—as one of the biggest barriers to women’s progression in the workplace. We know that employers still discriminate against women of childbearing age when recruiting, even though that is against the law, but it is when children are born that the gap really begins to grow, with women being passed over for promotion or moving into part-time work.
As part of his justification for the policy of shared parental leave, Nick Clegg said:
“if both sexes are equally likely to take time out of their career to look after young children, and if both are equally likely to go part-time to help them juggle work and home—employers won’t have an excuse for letting women fall behind.”
It is a simple premise: we can make great progress towards evening out the playing field in the workplace by giving parents the choice and removing from employers the supposition that a woman in her 20s or 30s is less dependable than a man.
Such an approach must go hand in glove with efforts to change perceptions among male workers as well. A recent survey by Hays Recruitment Services found that nearly two thirds of workers say that men who take up their share of parental leave are less committed to their career.
This Parliament will soon have an opportunity to change the culture of organisations in public control, so that governance reflects wider society, through gender balance. In the Gender Representation on Public Boards (Scotland) Bill, we will set a new standard in gender equality in the workplace and challenge industry to follow our lead.
We also need to do more about childcare, extending the debate far beyond the public funding of hours. The MacLean commission for childcare reform recommended flexibility that would give parents a range of options and make it easier for women, in particular, to re-enter and remain in the labour market. Until we get that right and address societal pressures around expectations of motherhood, we will continue to fall behind.
The committee’s estimate of a 16 per cent gap between male and female earnings in this country is more than 10 per cent adrift of the 5 per cent gap in Denmark. Although the needle has shifted over time, it is clear that our efforts have been unequal to the challenge. I want to be able to go home tonight, look my three-year-old daughter Darcy in the eye and explain to her that, whatever path she chooses, she can expect exactly the same recognition and reward as her brothers. The report takes us some way towards that.16:13
I thank everyone from the public sphere who engaged with the committee by providing submissions and commenting on social media on their experience of the gender pay gap. Their testimonies really informed our questioning and report. The best reports come out of inquiries in which the people of Scotland have been very involved.
I point to the amount of media interest that our inquiry received. When the media pay attention, it means that what we do permeates into civic society. I took part in two Radio Scotland “Call Kaye” phone-in sessions on the issue, and I was on an episode of “Woman’s Hour”—
I got it in, Jackie—there you go.
I know that other committee members were interviewed, too. Such engagement prompts a national conversation, which is what the issue desperately needs.
I want to use my time in the debate to talk about the limitations of the gender pay gap reporting obligations. As we know, new reporting legislation from the UK Government will affect companies that have more than 250 employees. I remain unconvinced about the effectiveness of the legislation in Scotland, for a number of reasons.
Most obvious is that the legal duty compels only very large companies to report their gender pay gap, but in Scotland SMEs make up a vast percentage of our economy. As a former small business owner, I completely understand the pressures that formal and compulsory reporting put on a very small business. I do not think that any member of the committee argued for reporting to be made compulsory for all businesses. However, we recommended that the Scottish Government consider how we might better capture a picture of the gender pay gap challenges in our economy.
Does the member accept that Page\Park Architects, a small employer in my constituency that we visited, has only about 40 employees but could produce its gender pay gap figure very easily?
I absolutely accept that. I actually had a discussion with Ash Denham about where the threshold should be. Producing the figure is not exactly onerous, and it is certainly the right thing to do.
We might capture the picture through existing channels. For example, gender pay gap reports might be asked for in public procurement situations, or in Scottish Enterprise or Highlands and Islands Enterprise account management situations. Fair work reporting stipulations are not a new idea for companies that seek to tender for public contracts or to access business support. Such measures might change business behaviour. Like it or not, although we might be convinced of the business benefits of closing the gender pay gap, many companies still are not. The effect would reach even further if companies made demands on their supply chains through procurement contracts.
However, reporting just reveals the problem—the legal duty to report does not compel companies to put any kind of action plan in place if their gap is significant. That was apparent at one employer that I visited, which was concentrating on getting a report together but had not given any thought to what it might do to address what was in that report.
In the committee’s report, we not only encourage all reporting businesses to create an action plan, but ask the Government to provide guidance on what that action plan might include. Any company looking to address its gender pay gap could do a lot worse than read our report or view the evidence that was given to us by organisations such as Close the Gap, Engender, Women’s Enterprise Scotland and the fair work convention. I would like any guidance that the Government introduces to be rolled out to all businesses, not just to those with 250-plus employees.
My colleagues have talked about the report’s findings on the importance of closing the gap and on effective mechanisms that companies have used to close the gap, and I will not list those again.
Companies doing progressive, fair and innovative things—the right things, as Patrick Harvie said—were enthusiastic about what that meant for them and their employees. However, we must recognise that, for some reluctant employers, a business and financial argument—one that I am confident will be compelling—needs to be made. Companies without gender pay gaps perform better, attract and keep talent, and have a diversity of approaches, views and skills that makes their work and products better. Those things alone have a massive effect on the bottom line. Addressing the gender pay gap is the right thing to do, but we must make clear to those for whom that is not a motivating factor—lets us face it, there are some people like that out there—that it is also the smart thing to do.
In closing, I say this to companies that have closed the gap and those that are working hard to do so: “Spread the word about the financial and business benefits, analyse the improvements to your bottom line and tell the world. Gender pay gap reporting in itself is not answer—you are the answer.” We should not only ensure that it is reputationally and socially unacceptable to have a pay gap, but make it as clear as we can that it is not good business.16:18
I welcome this opportunity to speak about the Economy, Jobs and Fair Work Committee’s recent report. As a new addition to the committee’s ranks, I was not directly involved in its gender pay inquiry, but I am pleased to congratulate my fellow committee members on the body of work that they produced and on their contributions today.
I welcome the continuing work to address the historical injustice of the gender pay gap and unequal pay between men and women. There can be few things as transparently unfair as failing to pay people the same money for doing the same job, not because of what they do but because of who they are. However, the committee’s focus was wider than that. It looked at differences in opportunities—or at least perceptions of opportunities—that have a clear gendered element, at distinctions between types of occupation that affect even the youngest generation of working people, and at the particular issues around having a family and the choices that people can make.
There has been significant progress recently. From this year onwards, larger businesses will be obliged to publish their gender pay gap figures. That is a significant step in increasing transparency and ensuring that, where issues exist, they are addressed. At the top end of the employment market, the proportion of women on FTSE 100 boards has more than doubled since 2011, but in the wider economy women often find themselves pushed into lower-paying jobs. There are several possible explanations for that, from the sharing of parental responsibilities to issues to do with skills, which I will touch on in a moment.
We know that, for many women, increases to the national living wage and being taken out of paying income tax altogether have provided an additional degree of financial security, but the question of occupational segregation remains significant. To take one example that has already been mentioned, the number of women entering STEM jobs remains worryingly small, despite the often higher pay and opportunities that those professions provide. There is precious little evidence that that will be remedied in the near future. The numbers of young women in schools studying physics, computing and other technical subjects are still at a low level. If anything, the involvement of young women seems to drop off by the time they reach university, college or apprenticeships.
We have seen cuts to STEM education in recent years, but it must be as clear as day that we require more STEM teachers in Scotland and more work to reverse some of the harm that has been done to our colleges. In addition, more girls must be involved in STEM from the earliest ages. To achieve that, STEM subjects must be promoted as a viable career option for young women. That requires closer working between schools and industry and a far greater focus on careers guidance.
Often very blunt gender stereotypes are in place for children at an early age, which can determine what careers children look towards. We can address that problem only by tackling it at a similarly early stage and ensuring that all children are open to the breadth of careers that are available to them. That is part of a slightly wider point. To what extent does our careers guidance prepare young people effectively for work? To what extent are technical and scientific professions promoted? To what extent are the routes into those professions other than through university promoted?
I look forward to the Scottish Government’s STEM strategy, which is due for publication soon. If we are to see change within a generation, the work must commence quickly and be radical rather than piecemeal.
Scottish Conservatives have previously raised concerns about diversity in the modern apprenticeships programme. Gender differences arise not only across the scheme as a whole but when it is broken down into individual frameworks, and some of the very traditional divisions remain. The committee noted that “little progress” has been made here and, by some measures, the situation is getting worse. The target in “Delivering the Young Workforce” to
“reduce to 60 per cent the percentage of Modern Apprenticeship frameworks where the gender balance is 75:25 or worse by 2021”
is far from ambitious, yet there seems to be problems in making modest steps in that direction. Perhaps the roll-out of foundation apprenticeships across Scotland and the closer links with schools present an opportunity to challenge that dynamic.
A feature of the committee’s inquiry was evidence that the problems leading to women receiving lower pay are more present in the Highlands and Islands than they are in Scotland as a whole. Highlands and Islands Enterprise’s submission showed that gender segregation of careers and sectors was more pronounced in the region. HIE’s research also showed that women are more aware of jobs in sectors that are perceived to be lower paid. The contribution that underemployment among women makes to differences in pay is compounded in more rural areas, with HIE pointing to multi-occupational working and the level of part-time and seasonal employment as being significant.
HIE’s work is welcome, but it is clear that the roots behind several of the issues begin at an earlier point and that we need schools, business, enterprise agencies and other public sector bodies to have a more unified focus if we are truly committed to seeing change.
Another component that I welcome is the Digital Scotland publication “Tackling the Technology Gender Gap Together”, which HIE, Skills Development Scotland and other bodies are working on together. It makes many of the points that I have spoken about today and its conclusions are very much worth looking at. However, I question whether the identified problems are being addressed for Scotland’s young people in practice and in the level of resource being directed.
To conclude, many of what are long-standing problems will require real focus and resources to address. The benefits, however, will flow not just to individuals but to the wider economy. Again, I thank the committee for its report.16:23
I thank the Economy, Jobs and Fair Work Committee for its work in leading an investigation into this very important topic and for the comprehensive report that it has produced. As parliamentary liaison officer to the Cabinet Secretary for Economy, Jobs and Fair Work, I take great interest in all the committee’s work, but particularly its work in a subject area as key as the gender pay gap.
The potential impact to the economy of balancing the gender pay has been well documented—the committee’s report says that gross domestic product could increase by £17 billion were that to happen. That, of course, assumes that there would be no gender displacement and that women entering the workforce or increasing their hours would not displace men in those roles. That is a reasonable assumption, given the growing skills shortages that we see in the labour market, as highlighted in the report. Furthermore, that deficit is set to increase as a consequence of Brexit.
As the report highlights, there are definitional issues around quantifying the gender pay gap. Issues such as whether to use mean or median and weekly or hourly rates of pay, whether to include or exclude overtime, and the impact of lower hourly rates for part-time work all make quantification—and hence international comparisons—difficult. More work needs to be done on that. We need to understand who in the world is better at this, and to seek to learn from them.
We can see wide variations in the data. There is a clear age-related impact, with the pay gap being significantly smaller for age groups under 40 than it is for those above 40. Whether that is a persistent phenomenon, a consequence of maternity leave and return-to-work barriers or a positive trend, such as the greatly increasing numbers of young women who are entering professions such as law, which will have a consequent impact on older age cohorts in coming decades, is not yet clear. That is an area in which greater understanding would be valuable.
Although examples of pay inequality, whereby women are paid less than men for the same or similar work, still exist, the key drivers of the gender pay gap are highlighted as being occupational segregation, gender variations in part-time employment rates and differential promotion rates. As the report highlights, occupational segregation is often a consequence of gender-based stereotypes, which can exert an influence from an early age and have an impact on career choices. There are no prizes for guessing which two of my four children—a lawyer, a vet, an engineer and an economist—are the girls. That represents an epic fail in the McKee household, so members should not take any lessons from me on gender career stereotypes.
Despite my failings, the area is one that requires focus. Women are expected to go into the caring professions and men into technical work. The focus on getting women into STEM careers is critical. Although that focus has been on the agenda for some considerable time, in many areas limited progress has been made. In my engineering class, only 10 per cent of the students were women. Even then, gender balance was well understood as an area in which improvement was needed. Thirty-five years later, progress has been limited, but the experience in the legal profession and some medical disciplines shows that progress can and is being made.
It is a two-way street. Getting more women into STEM careers means getting more men into traditionally female-dominated jobs, for example in the care and early learning sectors. As the report highlights, seeing more men in the traditionally female-dominated carer-type roles will help us to break the ideological link between women and care and to challenge the idea of the female as caregiver.
The assumption that lengthy child-rearing career gaps for women are inevitable is another outdated gender stereotype that needs to be challenged. As the report points out, in Scotland in 2016, 8 per cent of women aged 16 to 64 were economically inactive because they were looking after the house or the family, whereas only 1 per cent of men were. When my children were at the pre-school stage, I was fortunate enough to be working a shift pattern that allowed me to take on responsibility for much of our childcare, while Mrs McKee returned to full-time work. Most are not so fortunate.
The report raises other important issues, such as flexible working and encouraging female entrepreneurship. I am happy to support such work as a member of the cross-party group on women in enterprise.
In summary, I welcome the report. It is clear that there are areas in which more understanding of the data and the steps that we need to take to make progress is required to enable us to deliver the societal changes and the economic benefits of closing the gender pay gap.
We have a little time in hand, so I can give all the closing speakers an additional minute. I do not think that you will have any difficulty with that, Ms Baillie. I ask you to close for Labour, please.16:28
Sorry—[Interruption.] It went down the wrong way. I am not the first woman today to have a coughing fit. The other one was slightly longer. [Interruption.]
Take a moment.
It is okay—and I do not need a lozenge, either.
Speaker after speaker has acknowledged that women’s employment is more precarious than men’s. We are the part-time, low-paid workforce. Many of us are on zero-hours contracts and employed in the gig economy. We are more likely to be consumers of public services, more likely to be in poverty and more likely to be in receipt of social security benefits. Far too many women are in underemployment, working well below their qualification level. That is such a waste of talent and a waste for our economy.
As I said earlier, closing the gender pay gap would inject £17 billion into the Scottish economy. That matters even more now because of the fiscal framework, because if we do not sustain levels of growth that are the same as or higher than those in the rest of the UK, we might be on the end of a block grant reduction. Let us take a year-on-year comparison. Scotland’s economy grew by 0.2 per cent over the past year. The equivalent UK growth was 1.5 per cent. That may have serious implications for what we receive through the block grant, and I do not think that the Scottish Government has woken up to that.
Closing the gender pay gap is a no-brainer if we are serious about our economy and our long-term finances. The causes of the pay gap are common across the world, but some countries have been better than us at closing it—Belgium, Luxembourg and Norway, to name but a few. We need to understand what they do that works and copy them unashamedly.
Let me highlight some of the key recommendations that many across the chamber have touched on. The first recommendation is a national strategy with an action plan and measurable targets. It makes sense when you have a complex and interconnected set of problems that you need to have a plan. The response from the Government is to have a scoping exercise to determine feasibility. That is a little weak. Why can you not just say yes, there will be a national strategy, and then work through what it needs to cover?
The second point that has been raised is the role of the enterprise agencies. Women account for 49 per cent of start-ups but only 3.4 per cent of growth companies. For years, research undertaken by Women’s Enterprise Scotland and others has pointed to the need for gender-specific support for women-led businesses, but it really has not been provided. If GDP in Scotland reflected women starting up in business at the same rate as men, we would contribute £7.6 billion to the Scottish economy. What is not to like about that? The Scottish Government has pledged to double the women’s enterprise budget. It is only £200,000 at the moment. Just think what we could do if we gave that initiative more money, never mind mainstreaming consideration for women’s enterprise and tackling women’s economic inequality as part of our enterprise agencies.
While we are on the enterprise agencies, we should put our money where our mouth is. The Scottish Government should redesign the business pledge. It is not fit for purpose on gender equality. For those businesses that get millions of pounds in regional selective assistance, we should be asking for gender pay gap reports and action plans as standard. I do not think that the Scottish Government’s response agreed to that. Where is the political will and the priority? If we do not embrace the recommendations, little will change.
Gillian Martin was right to talk about the limitations of gender pay gap reporting as proposed by the UK Government. The majority of companies in the Scottish economy have fewer than 250 employees, so the new requirement to report the gap will not touch them. She was also right to ask how we could use procurement, or even enterprise agency account managed companies, to make a difference. I am not sure that I saw a positive response from the Scottish Government on that.
Close the Gap tells us that existing responses to tackling the pay gap are insufficient. Together with Engender, it has been clear about the need for a national strategy. So tell us, minister, are you going to do this? I said that the Scottish Government’s response was weak. I would rather be wrong about that, and let me tell you why. Your response refers to the fair work convention, inclusive growth, enterprise agency activity and the business pledge, all of which are, in and of themselves, positive initiatives, but they do not really engage with tackling the gender pay gap.
Let us get behind the committee report. It is bold, ambitious and challenging to us all, and I want the Scottish Government to be equally bold and ambitious. We have a chance to change things for generations of women, but if you just want to carry on as before, it will be 140 years before we close that gap. Frankly, minister, our daughters cannot wait that long. Neither can our economy.
My goodness—you did not use the entire seven minutes.
I can continue.
No, thank you.
I remind members about the use of “you” and “yours”. In this Parliament, you speak through the chair. We are all slipping into a little habit that I suggest we slip out of.16:34
In closing the debate for the Scottish Conservatives, I begin by pointing out the unity that is apparent among members in our determination to close the gender pay gap, even if there are slight differences in how we think that is to be achieved. I pay tribute to my colleague Gordon Lindhurst and all the members of the Economy, Jobs and Fair Work Committee for working so diligently to produce the report. The Scottish Conservatives welcome it and its recommendations.
Women in the workforce continue to be concentrated in low-paid industries and part-time work. We share the view of many individuals who tweeted their opinions. The tweets ranged from people saying that
“valuing women’s work means recognising”
the value of
“women’s contribution to the economy”,
to people saying that
“when women thrive, we all benefit”.
There were many others.
Many speeches by members from across the chamber have highlighted a lot of the aims that many of us share in respect of trying to close the pay gap. Jamie Halcro Johnston highlighted evidence that the gap is particularly marked in the Highlands and Islands, Dean Lockhart pointed out that the problem is not unique to Scotland, and Oliver Mundell talked about the value of women occupying leading and public roles.
Jackie Baillie expressed concern at the state of the Scottish economy and stated that if growth suffers, that affects the gender pay gap, and Ash Denham referred to the PWC report and the motherhood penalty, which I will come back to later. Alex Cole-Hamilton outlined a whole-systems approach to gender discrimination. Many other members—too many to mention individually—made valid and useful points, although some points were made with which we cannot agree.
However, closing the gap is not only the right thing to do, as Patrick Harvie made clear: the potential economic benefits of doing so have been highlighted by a number of bodies, including CBI Scotland, which wrote in its evidence to the committee that
“closing the gender pay gap increases the competitiveness of individual companies and the profitability of the economy as a whole.”
That is a positive view—especially when seen alongside further anecdotal evidence. However, as the committee noted, more study needs to be done to confirm the correlation between bottom-line improvements and closing the gender pay gap. Again, that is something that we would welcome.
Other proposals made by the committee, including the creation of a more gender-diverse apprenticeship programme for women returning to work, are positive steps in the right direction. Similarly, we hope that the Scottish Government will note the committee’s recommendations regarding the calls to boost the number of public sector jobs that offer flexible working hours, for more recognition of the role of the care sector, and to put more emphasis on getting enterprise agencies to address gender pay issues in their sectors. In a country in which only 20 per cent of SMEs are owned by women, the recommendation that the Scottish Government and its agencies review the funding streams that are available to new and existing female entrepreneurs is very welcome—in particular, in the light of anecdotal evidence that male entrepreneurs are more successful in obtaining capital than female entrepreneurs are.
We heard members talk about the need for us, as a nation, to do more to encourage more girls to study science and technology subjects. With women holding only 18 per cent of jobs in the well-paid technology sector, and a mere 9 per cent in engineering, there is huge scope for girls who are able to study such subjects. In 2015, Education Scotland highlighted the fact that girls made up only 20 per cent of those who were studying advanced higher computing and 28 per cent of those who were studying what was then the new higher physics course. Those figures are disappointing, as is the low uptake of STEM subjects by girls at college and university levels, and the situation contributes to gross underrepresentation of women in well-paid jobs in those sectors.
Members highlighted caring issues as another reason for the gender pay gap. Whether the care is provided to children, or to sick or elderly relatives, it is a role that is still very much played by women. Many employers fail to recognise that and continue to show a lack of flexibility on working hours, which leads more women to seek part-time work.
A particularly troubling section in the report refers to what is described in it as the motherhood penalty, which is the pay gap between working mothers and women without dependent children. The penalty can mean that the pay of returning mums falls behind that of other women by as much as 11 per cent. On that issue, I found the comments to the committee from family friendly working Scotland to be particularly salient, as were the words of Professor Loretto, who highlighted the issue of the work choices of grandparents of working age being affected by their taking on caring roles.
The Scottish Conservatives see the report as a starting point. We support the recommendations and look forward to the Scottish Government and all sectors of our economy—public and private—building on those recommendations and doing their bit to close the gender pay gap.16:40
I thank members for their contributions. There has been broad agreement. It is clear that no one in the chamber, not least the Scottish Government, is not serious about the agenda. I regret that Jackie Baillie feels that our response to the report is “weak”, but she is entitled to her perspective. Of course, it is entirely incumbent on her to push us to do more, and I expect her to do that. I have had another look over how we responded to the committee’s recommendations, and my observation is that virtually all of them tally entirely with work that we are taking forward. Clearly, there are areas that we can look at again; I am always willing to do that.
I agree with Jackie Baillie that it is important for us to engage in the agenda. She referred to her daughter, and Alex Cole-Hamilton mentioned his. I have a daughter, too, and I do not want her to grow up in a society—no: let me put it in a positive way. I want her to grow up in a society in which there is no gender pay gap. That is my aspiration for her and for all our daughters.
Of course, some of the issues that persist are entrenched and long standing. They are attitudinal and they start very early, when our children are young. Ivan McKee was probably being a little hard on himself in that regard; I am sure that he is very proud of all the achievements of his children. I believe that every member who has spoken is totally and utterly committed to the agenda, but I suspect that we will ourselves be susceptible to lapsing into using language and providing toys and so on that reinforce gender stereotypes. We have to start by reminding ourselves that we must seek to avoid doing that.
I will pick up on some issues that have been raised. Dean Lockhart mentioned the UK Government’s regulations on private sector gender pay gap reporting. I welcome those as being at least an acknowledgement of the systemic pay inequality that women experience, but I agree with Gillian Martin and Jackie Baillie that they are not in themselves likely to drive the change that we need. They are rather limited because of the threshold of 250 employees, which excludes the vast majority of private sector companies and most third sector organisations in Scotland. Clearly, we cannot alter that legislation, which is reserved, but we can lead by example; we have a significantly lower threshold for our public agencies here in Scotland.
Gillian Martin and Jackie Baillie spoke about efforts that could be made through our enterprise agencies relating to the provision of regional selective assistance grants and account managed companies. We are going through an enterprise and skills review, but we continue to explore with our agencies how we can increase the number of businesses that produce pay gap reports. We are looking at that very seriously, but right now the agencies can signpost businesses to relevant available guidance, such as Close the Gap’s think business, think equality toolkit, which is available to companies of all sizes. In a moment, I will come back to why it is important to talk about the issue in economic terms.
Ash Denham mentioned the motherhood penalty. I am acutely aware of some of the issues that drive that, which is why we have established a working group to tackle pregnancy and maternity discrimination, which I chair. The group involves many of the inquiry witnesses, including the NHS, Police Scotland and the Equality and Human Rights Commission. Those issues are why we have also established a women returners programme. I willingly accept that that programme is limited at this stage: it is designed to pilot initiatives so that we can see good practice. I have to say here and now that it will never be something that the Government can entirely lead. We need all sectors, particularly the private sector, to be willing to step up to the plate. We want to get good practice from the pilots so that we can work with employers to see more support for women who are returning to the workplace.
Does the minister agree with Audit Scotland that the cuts of 152,000 college places have impacted on women’s ability to return to work?
We have set out our clear commitment to support 116,000 full-time equivalent places and that is what we have provided. Last month, I announced a flexible workforce development fund, which will allow employers to support those who need to be upskilled in the workplace. Many women will benefit from that. We have refocused individual learning accounts as individual training accounts, which can be delivered through the college network and can be designed to support upskilling of low-paid women.
Alison Harris spoke about the need to support flexible working. We are signed up to that agenda: we fund and participate in family friendly working Scotland. She also mentioned a committee recommendation that referred to the Government, our agencies and the Scottish Parliament. I do not think that the Presiding Officer would like me to veer into what the Scottish Parliament might do, and I am sure that the parliamentary authorities will reflect on the recommendation. It asks that all of us
“ensure that all roles are advertised as flexible, agile or part-time, unless there is a business reason not to do so.”
All Scottish Government staff, including senior civil servants, are encouraged to participate in our flexible working hours scheme. We require our managers to consider all flexible working requests objectively and sensitively.
There is much more that I want to say, but I am not going to be able to say it.
You have some time. I can give you another two minutes.
Well, let me get on with it. That is what I will do.
I could not have put it better myself.
Thank you, Presiding Officer—I think.
I want to touch on childcare in two ways. First, our expansion of childcare agenda will itself support many more families to be better able to balance their work and caring responsibilities. I want to assure Jackie Baillie that I completely recognise the economic opportunity not just for those who benefit from childcare but for those who provide it. We have provided local authorities with an additional £21 million to invest in the first stage of the workforce expansion. We have a commitment to have an additional 435 graduates working in nurseries in the most deprived communities by August 2018. To support that commitment, we are providing £1.5 million in additional funding to the Scottish Further and Higher Education Funding Council to increase teacher training in childcare-related graduate places. Skills Development Scotland is providing training opportunities for childcare, and we have a commitment to pay the living wage to all those who deliver funded entitlements.
I do not want anyone to be under the impression that I do not take that sector seriously. In Patrick Harvie’s language, I do not want to “undervalue” the sector. Perhaps we need to switch the language that we use: instead of saying that the sector is undervalued, let us show leadership in Parliament and say how we value the sector. We will deliver as an Administration.
I invite the minister to show leadership by making the sector a key growth sector that is the responsibility of our enterprise agencies, as well.
I am happy to speak to the enterprise agencies. I make the point that this is a whole-system commitment and our skills agencies are engaged.
I will probably have to close on this next point—
Yes, you will.
Richard Leonard was right to identify the need for us to tackle low pay. We have done well in Scotland: 80 per cent of our population are paid the living wage or more. I accept absolutely that we need now to focus on the remaining 20 per cent, which represents women in low-paid work more than men. We promote the living wage and I want to see more than an “in principle” commitment to paying the living wage: I want a hard and fast commitment. Mr Leonard might have been referring to something else in his comments, but I will let that stand.
Let me finish—
Yes. Please do, now.
This will be my final point, Presiding Officer.
Patrick Harvie was right to talk about the intrinsic good and self-evident worth of closing the pay gap. I totally agree with that point, but it is important that we talk about it as an economic imperative. It is the same with the fair work agenda; payment of the living wage, flexible working and workers’ involvement in the workplace increase retention, reduce absenteeism and increase productivity. Closing the pay gap can achieve the same.
There we must end, or you are cutting into the committee summing up.
I agree with—
No, minister. Thank you very much.16:50
I thank the Presiding Officer for protecting the back benchers against the front benchers.
Members: Hear, hear.
I start on a consensual note by thanking everyone who has taken part in today’s debate and I emphasise our thanks as a committee to the wide range of witnesses. We spent a considerable time on the issue and, as sub-groups, we visited a number of businesses around the country, which was tremendously helpful, certainly for me. I thank the Scottish Parliament information centre for its help and I thank the committee clerks, and I particularly mention our adviser, Jane Gotts, who had a tremendous input.
It is fair to say that the debate has been broadly consensual, and that is true of the study that the committee did. However, it must be accepted that some committee members are more consensual than others—I shall leave it to members to decide who I might be referring to.
I will start with general points that the convener, in opening on the committee’s behalf, was not able to spend a lot of time on. I will then mention individual contributions.
A number of speakers have mentioned occupational segregation, which Close the Gap also mentioned. Throughout its inquiry, the committee sought to understand the challenges that women who work across the public and private sectors still face. As the convener said, the pay gap impacts on women at all stages of their working lives. The committee heard many reasons for that, and occupational segregation is a key factor. Women have historically clustered in sectors that are traditionally low paid—they are sometimes called the five Cs: cleaning, caring, catering, clerical and cashiering—and that pattern continues. There are fewer women in higher-paid sectors such as engineering, IT and technology. Equate Scotland told the committee that only 18 per cent of technical jobs and 9 per cent of engineering jobs are held by women, as Alison Harris said.
The committee heard quite a lot about the leaky pipeline; if people do not look at anything else in the report, looking at the infographic on that is worth while. It shows that, even when things start well, there is drift through the system. Women can fall out of certain sectors, especially if they take a career break. STEM is an area with high-paying jobs and increasing opportunities, so plugging the leaky pipeline is essential to reducing the gender pay gap. Some factors that witnesses said cause leaks throughout the pipeline are starting school—young children say very early that there are boys’ jobs and girls’ jobs; a lack of role models in STEM industries, with fewer women in senior positions; and difficulties in returning to the workforce.
Apprenticeships have been mentioned by a number of people, including the minister and Jamie Halcro Johnston. The committee noted the successes of the modern apprenticeship model in providing opportunities for young people and employers alike but, despite considerable efforts, little progress has been made in addressing occupational segregation through the modern apprenticeship system. In 2015-16, for example, there were no female apprentices in the civil engineering specialism in construction. The committee notes the work that is being done by Skills Development Scotland, which is welcomed.
The reporting legislation has been largely touched on, particularly by Gillian Martin, who spent most of her speech on it. We heard quite a lot of evidence about the fact that the UK legislation requires organisations to have 250 staff or more to report, which leaves out rather a lot of people in Scotland, as Dean Lockhart said.
Targets were not mentioned much, but we heard a bit about them. There was some sympathy on the committee for the idea that there should be a bit more in the way of targets. Targets have value because they move things forward.
On conditions on business support and procurement, the committee heard that there might be an opportunity to address the gender pay gap by placing conditions on economic development aid or procurement in key sectors of the Scottish economy.
Scottish Enterprise and HIE have a slightly difficult job, so I have some sympathy for them, but we were unhappy about their attitude. Other groups accepted that there is a problem and wanted to challenge it, but we got the impression at times, especially from Scottish Enterprise, that the enterprise agencies wanted to attract businesses and did not want to put them off by telling them that they had to have more women in their organisations.
I will use my final few minutes to touch on some of the things that members have said. Gordon Lindhurst emphasised the difficulties of measuring the pay gap and said that it is complex. I was glad that the minister appreciated and agreed with that point.
In her two speeches, Jackie Baillie was perhaps one of the more aggressive speakers—
Just a minute, Mr Mason. I cannot hear what you are saying because of the casual conversations that are taking place across the chamber.
I realise that I am keeping members from the upcoming debate.
I am listening.
Thank you, Presiding Officer. I appreciate that.
Jackie Baillie brought up the question of how we measure GDP and Patrick Harvie was correct to challenge her on that. The committee will look at that in its inquiries on data and the performance of the economy. However, in one of our subsequent evidence sessions, we have already had evidence in the form of a clear statement from a witness that growing the economy does not automatically make it fairer. I certainly believe that, even if the economy does not grow, we need to make it fairer today.
Other members, including Ash Denham, talked about the positive impact on the economy of women fulfilling their potential and working with their qualifications. Richard Leonard talked about more women being on the living wage and the fact that there are conceptual living wage employers; I am sympathetic to that point.
Patrick Harvie made the point that putting the Queen at the top of the whole system as head of state does not automatically mean that women at the bottom will do better; we would probably all agree with that.
Alex Cole-Hamilton talked about devolution. We must accept that there are many issues around the gender pay gap that do not fall under devolution and which we do not yet have control over.
The gender pay gap cannot be addressed overnight. Even in Sweden, the gap is still at something like 13 per cent. Addressing the gap will take time. The committee will continue to monitor this policy area in budget scrutiny work and we will consider carefully the Scottish Government’s response to our report. There is no doubt that supporting women at all levels and in all sectors to achieve their potential will benefit Scotland’s economy. That would be good for women and good for all of us.
The next item of business is consideration of motion S5M-08013, in the name of Clare Adamson, on behalf of the Standards, Procedures and Public Appointments Committee, on a breach of the code of conduct for members of the Scottish Parliament.16:58
The Standards, Procedures and Public Appointments Committee has considered and reported on a complaint from Christian Allard about Alexander Burnett MSP. The complaint was that Alexander Burnett failed to declare his registered business interests when submitting written parliamentary questions in August last year. All the details of the complaint, the committee’s deliberations and the investigation by the Commissioner for Ethical Standards in Public Life in Scotland can be found in the annexes to our report.
The complaint alleged that Alexander Burnett had relevant business interests that related to a housing development in Banchory in Aberdeenshire. The complainer’s submission was that the conflict of interest arose by virtue of entries in the respondent’s register of interests.
The commissioner investigated the complaint and concluded that Mr Burnett was in breach of the Interests of Members of the Scottish Parliament Act 2006 and the code of conduct for MSPs. The committee unanimously endorsed the commissioner’s conclusion. Furthermore, we consider that the breach justifies the imposition of a sanction on Alexander Burnett.
The committee wishes to focus its recommended sanction on the specific breach that was complained about. Accordingly, it recommends that Alexander Burnett should be prohibited from lodging parliamentary questions for written answer for a period of two weeks, which will not overlap with any period of recess.
I take the opportunity to reiterate on behalf of the committee that declaring registered financial interests in any matter before taking part in proceedings of the Parliament that relate to that matter is an essential aspect of parliamentary transparency and accountability. Furthermore, it is a legal requirement under the 2006 act and the code of conduct for MSPs.
Before taking part in any proceedings of the Parliament, a member must always consider whether they have a declarable interest in relation to the particular matter that is being addressed in those proceedings. It is incumbent on members to make the appropriate written and oral declarations if they have a declarable interest.
That the Parliament notes the Standards, Procedures and Public Appointments Committee’s 10th Report, 2017 (Session 5), Complaint against Alexander Burnett MSP (SP Paper 200), and agrees to impose the sanction recommended in the report that Alexander Burnett MSP be excluded from submitting Parliamentary Questions for written answer for a period of two weeks, to occur from 23 October to 5 November 2017 inclusive.
The next item of business is consideration of business motion S5M-08099, in the name of Joe FitzPatrick, on behalf of the Parliamentary Bureau, which sets out a business programme.
That the Parliament agrees—
(a) the following programme of business—
Tuesday 24 October 2017
2.00 pm Time for Reflection
followed by Parliamentary Bureau Motions
followed by Topical Questions (if selected)
followed by Ministerial Statement: Delivering for Scotland’s British Sign Language (BSL) Community: Launch of the BSL National Plan
followed by Scottish Government Debate: Unconventional Oil and Gas
followed by Business Motions
followed by Parliamentary Bureau Motions
5.00 pm Decision Time
followed by Members’ Business
Wednesday 25 October 2017
2.00 pm Parliamentary Bureau Motions
Communities, Social Security and Equalities
followed by Ministerial Statement: Common Agricultural Policy Convergence Monies due for Scottish Farming
followed by Scottish Government Debate: Scotland and EU-UK Negotiations on EU Exit
followed by Business Motions
followed by Parliamentary Bureau Motions
5.00 pm Decision Time
followed by Members’ Business
Thursday 26 October 2017
11.40 am Parliamentary Bureau Motions
11.40 am General Questions
12.00 pm First Minister's Questions
followed by Members’ Business
2.30 pm Parliamentary Bureau Motions
2.30 pm Ministerial Statement: STEM Strategy for Education and Training
followed by Scottish Government Debate: Scotland: The Hydro Nation, Maximising the Abundant Benefits of our Water Resources
followed by Business Motions
followed by Parliamentary Bureau Motions
5.00 pm Decision Time
Tuesday 31 October 2017
2.00 pm Time for Reflection
followed by Parliamentary Bureau Motions
followed by Topical Questions (if selected)
followed by Scottish Government Business
followed by Business Motions
followed by Parliamentary Bureau Motions
5.00 pm Decision Time
followed by Members’ Business
Wednesday 1 November 2017
2.00 pm Parliamentary Bureau Motions
Finance and Constitution
Economy, Jobs and Fair Work;
followed by Scottish Government Business
followed by Business Motions
followed by Parliamentary Bureau Motions
5.00 pm Decision Time
followed by Members’ Business
Thursday 2 November 2017
11.40 am Parliamentary Bureau Motions
11.40 am General Questions
12.00 pm First Minister's Questions
followed by Members’ Business
2.30 pm Parliamentary Bureau Motions
2.30 pm Scottish Government Business
followed by Business Motions
followed by Parliamentary Bureau Motions
5.00 pm Decision Time
and (b) that, in relation to First Minister’s Questions on 26 October, in rule 13.6.2, insert at end “and may provide an opportunity for Party Leaders to question the First Minister”.—[Joe FitzPatrick]
Motion agreed to.
Parliamentary Bureau Motion
The next item of business is consideration of Parliamentary Bureau motion S5M-08098, on a committee meeting.
That the Parliament agrees that, under Rule 12.3.3B of Standing Orders, the Social Security Committee can meet, if necessary, at the same time as a meeting of the Parliament from 11.40 am to noon on 5 and 26 October and 2 November 2017 for the purpose of considering the Social Security (Scotland) Bill.—[Joe FitzPatrick]
The question on the motion will be put at decision time.
There are three questions to be put. The first question is, that motion S5M-07946, in the name of Gordon Lindhurst, on the gender pay gap, be agreed to.
Motion agreed to,
That the Parliament notes the conclusions and recommendations contained in the Economy, Jobs and Fair Work Committee’s 6th Report, 2017 (Session 5), No Small Change: The Economic Potential of Closing the Gender Pay Gap (SP paper 179).
The next question is, that motion S5M-08013, in the name of Clare Adamson, on a breach of the code of conduct for members of the Scottish Parliament, be agreed to.
Motion agreed to,
That the Parliament notes the Standards, Procedures and Public Appointments Committee’s 10th Report, 2017 (Session 5), Complaint against Alexander Burnett MSP (SP Paper 200), and agrees to impose the sanction recommended in the report that Alexander Burnett MSP be excluded from submitting Parliamentary Questions for written answer for a period of two weeks, to occur from 23 October to 5 November 2017 inclusive.
The final question is, that motion S5M-08098, in the name of Joe FitzPatrick, on a committee meeting, be agreed to.
Motion agreed to,
That the Parliament agrees that, under Rule 12.3.3B of Standing Orders, the Social Security Committee can meet, if necessary, at the same time as a meeting of the Parliament from 11.40 am to noon on 5 and 26 October and 2 November 2017 for the purpose of considering the Social Security (Scotland) Bill.
The next item of business is a members’ business debate on motion S5M-07538, in the name of Edward Mountain, on a shortage of radiologists. The debate will be concluded without any question being put.
That the Parliament congratulates all of the people in NHS Highland and across the country who are working to overcome the reported shortfall of radiologists, which, it believes, is severely delaying the treatment of patients; recognises the additional work of the radiologists who are covering the staff shortages, and notes the view that the Scottish Government should match the commitment of these NHS employees and urgently address this issue.17:04
I thank all members who signed the motion, giving the Parliament the chance to debate what I believe is one of the most urgent issues impacting on the standard of patient care across Scotland. I would also like to thank the radiographers and radiologists across Scotland who are shouldering the additional burden that the shortfall in their numbers is causing, especially those I have met not only at Raigmore hospital but in other places and those who have contacted me from across Scotland asking for help.
By bringing this matter to our attention, they have shown a dedication to their profession. It is now time for us politicians to stand with them, to support and to help them. Let us be under no illusion—radiology is the heart of modern medicine. It is an essential part of speedy and accurate diagnoses of many conditions. In so many cases, patients rely on the expert opinion of a radiologist—and in some cases, a radiographer—to help to diagnose their ailments, which then allows for surgical operations to take place. The shortfall in radiologists across Scotland means that diagnosis and operations are delayed and patients are left waiting too long for vital treatment. It also means that radiologists and radiographers are working under intense pressure. The evidence speaks for itself: between 2010 and 2016, the number of scans undertaken increased by 65 per cent per year, while the number of radiologists to read them rose by 1 per cent per year.
What does that mean? Imagine that someone is waiting for a scan to be read, having been told that they might have lung cancer. Every day they wait seems like an eternity; they want and deserve a quick result. It is very frightening and I can tell members, personally, that it is very hard to bear.
This is a problem that is not going away any time soon, with at least 20 per cent of consultant clinical radiologists expected to retire in the next five years. According to the Royal College of Radiologists, only one Scottish health board is able to meet reporting requirements within staff contracted hours, which meant an annual bill of nearly £4.5 million on overtime and outsourcing alone in 2015-16.
The radiology recruitment crisis is being felt by all across Scotland, but perhaps no more so than by people in the Highlands, where imaging examinations have increased by 250 per cent. NHS Highland is unable to meet reporting targets, with around 8,000 scans still waiting to be reviewed. Just how many patients is that waiting to be told what is wrong with them? I can tell you: too many.
Safety fears have been raised internally by radiologists at Raigmore since 2014, when there were 13 of them. Now there are just 7.8 full-time equivalent staff members—two have left in the past six months; let us hope and pray that two more do not leave in the next six months. More than £300,000 is being spent annually by NHS Highland to have scans read. How many radiologists and radiographers would that employ? Probably enough to prevent the need to have those scans read outside the Highlands.
Here is another fact: at present, there are only two interventional radiologists at Raigmore and, frankly, that is not enough to deal with the problems in the Highlands. It is clear that the radiology team at Raigmore is overstretched and understaffed. They are almost below critical mass and, statistically, they are having to do one night on call every week.
The publication of the Scottish Government’s NHS Highland radiology review cannot come soon enough. The review must identify not only how many radiologists are needed, based on current demand, but why they cannot be recruited and why they are not being retained. It must also find solutions that will improve patient care in the short term.
This is not a time to hide behind the problem or to use political spin. Delivering an improved service for patients is the number 1 priority here; the issue is just too important for anything else. I believe that this is about people, not about politics.
The chairman of the Royal College of Radiologists standing Scottish committee stated earlier this year:
“A perfect storm of increased demand, no significant increase in consultant numbers or trainees, chronically unfilled posts and a tsunami of expected retirements in the next three years means that we need a sustainable solution now for the sake of our patients.”
Thus, I welcome the Scottish Government’s—albeit tardy—announcement of an additional £3 million to try to increase the number of radiology trainees in Scotland by at least 50 in the next five years. It is just a pity that that was not done three years ago, so that the current situation could have been avoided. However, I have to ask the Cabinet Secretary for Health and Sport how many of those trainees will be coming to the Highlands, because they are sorely needed. What has been announced is a step in the right direction, but it will take time to filter through to the front line.
Radiologists across Scotland must be recognised and praised for their dedication to their patients at a time when they are struggling under an increased workload. Highlanders are sceptical about losing local hospital and medical services, whether in Portree, Thurso, Wick, Raasay, Golspie or Strathspey, and seeing them centralised in Raigmore. They will now be even more concerned—rightly so—when they hear that there are not sufficient staff at Raigmore to provide the services that they are losing because of staff shortages at their hospitals.
It is time for the Scottish Government to match the dedication of radiologists and radiographers across Scotland, and I hope that we can do more to resolve this crisis. I look forward to hearing the other speeches in the debate.
We move to the open debate, with speeches of four minutes, please.17:11
First, I apologise to you, Presiding Officer, and to members for the fact that, because of a long-standing commitment, I cannot stay until the end of the debate.
It is standard practice to thank members for proposing a debate, and I thank Edward Mountain for this members’ business debate. I was speaking at a school last week when a child asked me how I got on with the regional members for the Highlands. My response was that there is a pile of work to do in the Highlands and Islands and that we will make more meaningful progress if our united aim is to serve the Highlands and Islands.
I am pleased that Edward Mountain references the commitment of national health service employees in his motion. I know at first hand, as will many of us, that nurses, doctors and other healthcare staff do a power of work for our patients. Having seen what our nurses in particular do from the vantage point of having been a patient and being related to or friendly with staff, I know that they deserve our continual and authentic praise. The challenge for managers and for decision makers like us is to make sure that they are as well supported as possible, which brings me to the subject matter before us this evening.
This is, of course, a timely debate—I do not know whether the timing was intentional—because it comes immediately after the Royal College of Radiologists welcomed a statement from the Scottish Government and commended the Government’s efforts to resolve the challenges that, we all accept, face us in radiology services. Last week, the Cabinet Secretary for Health and Sport, Shona Robison, announced an additional £3 million to increase the number of radiology trainees in Scotland by at least 50 over the next five years. That is absolutely the right thing to do, because the proportion of radiology trainees to consultants, compared with the proportions in other hospital medical specialties, is one of the lowest in Scotland.
There is particular work to do, then, in getting trainees interested in choosing radiology and then going on to train as consultants. Of course, that takes years, which is why long-term funding is critical. It is a case of looking to the next five, 10, 20 and 30 years to ensure that we are not revisiting this debate. In five years’ time, we want to be able to look at the power of work that will have gone on and commend staff for what they are doing.
Edward Mountain mentioned the unique situation in the Highlands. There has been an increase in the number of consultant radiologists everywhere in Scotland, except in the Highlands. That demonstrates to me that it is not just a simple matter of throwing money at something. We know fine well that when it comes to recruitment, there are unique and special challenges in the Highlands that will take more than hard cash to resolve. We must ensure that key housing is available in the right places; that consultants can access continuing professional development and link them up with hospitals elsewhere; and, critically—this is not often talked about—offer trainees opportunities to work in rural areas early in their careers. A number of colleges have told me that if rural modules—for want of a better phrase—or traineeships are provided early in people’s careers, they are more likely to come back. As an add-on to that, if we can get more pupils in Highland high schools to choose to go and train as consultants in different disciplines, they are more likely to come back to the Highlands. The solution is bigger than just throwing money at something, although clearly we need to solve the long-term funding.
I end by noting that, in Scotland, 20 per cent of consultant radiologists, or one in five, are from outside the UK. For that reason, putting in place more stringent visa requirements and deporting people are not going to help. We need to make sure that working in Scotland is an attractive proposition and make it easier to recruit.17:16
I congratulate my colleague Edward Mountain on securing this important debate.
In June 2017, only 86.9 per cent of patients in Scotland who had been urgently referred with suspected cancer began treatment within the 62-day target time. That is significantly below the target of 95 per cent. In NHS Grampian, which covers part of my Highlands and Islands region, the figure was even lower, at only 82.3 per cent. That was due in part to delays in diagnostic services such as radiology and is hardly surprising given that NHS Grampian saw a decrease in the number of whole-time equivalent consultant radiologists per 100,000 people between 2014 and 2015, compounding the region’s problem of already having one of the lowest numbers in Scotland of radiologists serving its population.
However, the problem affects not only radiology services and exists not only in the Highlands. Health services across Scotland are increasingly under pressure, and patients are facing increasing delays to services. The report on workforce planning that Audit Scotland published in July points to a range of specialties with similar consultant vacancy rates to radiology. That is not talking the national health service down and is not a criticism of the hard-working staff in our NHS, who are being let down by those higher up and by a Scottish Government that is getting workforce planning wrong across Scotland.
In August, I was contacted by a constituent in Moray who, having been diagnosed as needing cardiac surgery, had waited since the beginning of the year for treatment. On their behalf, I wrote to both the Cabinet Secretary for Health and Sport and NHS Grampian, which is their local board. In her reply, the cabinet secretary admitted that the three-month delay for my constituent’s surgery was
and said that, in this case, care had
“fallen well below the level I would normally expect a Board to deliver for their patients”.
However, a month after NHS Grampian acknowledged that it had received my letter, I am still waiting to hear back from it, and my constituent still waits for the surgery that they so desperately need to allow them to get back to their work and to their life.
The delays are not just affecting my constituents in Moray. In Orkney, which has an agreement with NHS Grampian, one constituent has been forced to wait for over 10 months for an out-patient clinic. They are still waiting, and they are not alone. The Orkney heart support group has said that it is
“aware that patients waiting to see cardiologists are experiencing extended waiting times often well in excess of the 12 week national limit”.
It goes on to say:
“We have expressed our concerns to NHS Orkney and they have acknowledged there is a problem but to date have no solution”.
The situation gets worse. I have now been advised by two different sources that some heart attack victims in Orkney are having to wait in beds in Kirkwall’s Balfour hospital for over a week for a bed to become available for specialist treatment in Aberdeen. If that is the case, delays in NHS Grampian now mean that beds are being blocked in Orkney and patients who have suffered heart attacks are being forced to wait for treatment. I have written again to NHS Grampian and to the health boards in Orkney and Shetland to get a fuller picture of the delays to services, how they are impacting on local patients and what is being done to reduce the delays and get patients seen and treated.
I thank Edward Mountain for bringing this debate to the Parliament, and I thank the thousands of NHS workers across Scotland who are doing their very best to see and treat patients as soon as they can. However, I say to the cabinet secretary and the Scottish Government that they must get on top of the delays. NHS services must be properly staffed and resourced, and workforce planning is a key part of that. Waiting-time targets should not just be aspirations; they are there to be met. I have heard the issue described as a looming crisis, but there is nothing looming about it.17:19
I remind members that I am the parliamentary liaison officer to the Cabinet Secretary for Health and Sport. I also thank Edward Mountain for bringing this important issue to the chamber. I do not necessarily agree with the overall approach that he took, but it is an issue that needs to be raised.
I will relay some statistics on what the Government has done. The number of consultants in NHS Scotland with a specialty in radiology has increased by more than 41 per cent, to 317 full-time equivalents, in recent years. As Kate Forbes said, it is ironic that this debate has been brought to the chamber today, when the health secretary made announcements last week about £3 million of additional funding to increase the number of radiology trainees. As far as I can tell, that has been very well received by the radiologists and those working in the profession.
The Scottish Government has also enhanced the supply of doctors to fill radiology posts, with 26 new training places over the past four years—an increase of 20 per cent—and further training places coming in 2018. In addition, the national radiology implementation programme aims to develop a longer-term vision. Those are just some of the things that the Government has done, and I am sure that the cabinet secretary will talk a wee bit more about that. Edward Mountain raised the point that it is an issue that needs to be addressed, and that is why I am glad that the cabinet secretary and the Government have done that.
Kate Forbes finished on a very important point about the Brexit scenario, which is hanging over everything in United Kingdom politics at the moment. When Edward Mountain said that we should not hide behind politics, I wondered whether he actually meant that nobody should mention Brexit, but that is an important barrier.
Will the member take an intervention?
I have only four minutes. Will I get extra time?
I might think about that.
I will take the intervention, then.
I understand the problems around Brexit, and it is something that we have raised at the Health and Sport Committee. However, the problems in our health service did not start on 23 June 2016; we are debating this because, after 11 years under Fulton MacGregor’s party’s Government, we have a crisis in our health service.
I accept the member’s point, but that is why I started by giving some of the stats on what the Scottish Government has done to address the problem. What I am saying about Brexit is that it is not going to make things easier. It is not making it easier to attract highly skilled European staff to the country, and the Conservatives need to recognise that that is an issue.
I am not a Highland MSP and I know that the issues there are a wee bit different, but I want to talk about the issues in NHS Lanarkshire. I spoke to Calvin Brown at NHS Lanarkshire today to get some stats. All three of our major hospitals—Monklands, Hairmyres and Wishaw—are served by a fully staffed and equipped radiology department. Approximately 360,000 radiological examinations are carried per annum in NHS Lanarkshire, and each hospital is staffed and equipped for plain radiographs, ultrasound, computed tomography scanning and magnetic resonance imaging, so a lot of work is going on locally.
I had the privilege of visiting the Beatson institute, which is based at the Monklands hospital, a few months ago. I saw some of the radiograph work that is going on there in a staff team who certainly seem to be very enthused about their work; Edward Mountain also rightly mentioned that enthusiasm, which is found throughout the wider hospital community. In NHS Lanarkshire, there is a shortage of 3.3 full-time posts over those three hospitals. I am assured that the health board is working extremely hard to fill that gap and looking at all the different recruitment options.
To finish, I would like to say thanks to all the radiographers and everybody else in our NHS. They are working really hard, day in and day out. Keep up the good work.
Due not entirely to Mr MacGregor but to the number of members who still want to speak in the debate, I will be happy to accept a motion under rule 8.14.3 that the debate be extended by up to 30 minutes.
That, under Rule 8.14.3, the debate be extended by up to 30 minutes.—[Edward Mountain.]
Motion agreed to.17:25
I thank Edward Mountain for lodging the motion on this important subject, and I echo members in thanking our incredible and hard-pressed NHS staff for all the work that they do.
The shortage of radiologists in Scotland is pushing the field to “the brink of collapse”—those are not my words but those of the Royal College of Radiologists. According to the royal college, at a time when radiology has seen a significant increase in demand, imaging workloads having increased by 55 per cent between 2010 and 2015, the number of consultant radiologists has increased by just 3 per cent.
The most recent figures from the royal college show that Scotland has just eight radiologists per 100,000 people, compared with a European Union average of 12. The figure for consultants is even more dire, at 5.4 per 100,000. Across Scotland on average, 8 per cent of radiologist posts and 13 per cent of consultant positions are unfilled at any given time. Interview panels are regularly cancelled due to a lack of suitable candidates, and the college’s 2015 survey found that 68 per cent of advertised consultant vacancies initially failed to find anyone suitable. The problem is set to get worse, because 19 per cent of radiology consultants are due to retire within the next five years, and as many as 53 per cent will retire by 2030.
That is only half the story. According to the royal college, there are significant regional differences, and rural areas are struggling most. In my home region of Dumfries and Galloway, half—that is right, half—the consultant radiologist positions are not filled with a permanent member of staff.
The recruitment crisis is placing a significant financial burden on the NHS. In 2015, £5.25 million was spent on outsourcing radiology services to the private sector—an increase of £1.75 million on the previous year. Spending on locums and private agency staff has spiralled out of control under this Government; it increased by 113 per cent between 2011 and 2015.
It is clear that the crisis is impacting on patient diagnosis and treatment, not least in oncology. Cancer waiting times are the worst for a decade. Some 13 per cent of urgently referred patients are not receiving specialist cancer treatment within the target time.
I am sure that the cabinet secretary will tell us today that the Scottish Government has committed to increase the number of radiology trainees by 50 over the next five years. That is welcome, but not only is the number way below the 20 to 25 trainees per year that the Royal College of Radiologists estimates are needed, it takes at least five years to train a consultant radiologist. More needs to be done now to mitigate the crisis.
I hope, therefore, that the Government will listen to the proposals by the Royal College of Radiologists, including its call for a sustained programme to recruit more international medical graduates to fill vacant posts. That is an issue on which there seems to have been a lack of engagement by the Government and little progress towards resolving challenges that relate to General Medical Council requirements, visas, and NHS human resources.
Cancer Research UK, too, has put forward proposals to increase the number of radiologists in the short term. Those include making consultant contracts more flexible, to minimise early retirement; incentivising radiologists to train and work in health boards such as NHS Highland and NHS Dumfries and Galloway, where shortages are most acute; embracing a skills-mix approach, so that there is widespread and safe radiographer reporting; exploring international models for interpreting scans; and considering ways to support health boards through artificial intelligence, networked solutions and telereporting.
Ultimately, the solution lies in tackling the acute shortage of staff. I am sad to say that the recruitment crisis is not confined to radiologists. Earlier today, during parliamentary questions on health and sport, I highlighted the recruitment challenges that face NHS Dumfries and Galloway. The board has almost 150 nursing and midwifery vacancies, 26 allied health professional vacancies, 28 consultant vacancies—that is almost 22 per cent of posts—and vacant general practitioner posts in almost 42 per cent of GP practices.
Those figures and the subject of today’s debate are a damning indictment of 10 years of abject failure when it comes to NHS workforce planning by this Government.17:29
I remind members of my work as a clinical pharmacist for NHS Highland prior to my election last year.
Sir Edward Mountain identified a serious issue. Throughout the UK, there is a shortage of consultant radiologists, so imaging departments are having to work incredibly hard to keep up with demand for services. I thank them for their hard work in ensuring that quality is maintained in these challenging times.
Let us look at the context. Demand for radiology has risen steeply in recent years. Why? Rapid advances in technology have meant that imaging can be used much earlier in the diagnostic process. It is also frequently used to monitor the progress of disease and to perform image-guided treatment. The ageing population, which of course is very welcome, is another driver of demand. Radiology is a cornerstone of diagnosis and treatment, and radiologists are at the heart of patient care for almost all clinical specialties. Retirements from the profession are likely to sharpen the situation in coming years.
That is the current UK-wide picture, but those issues are much more pronounced in rural areas such as the Highlands. I assure members that the situation in Cornwall is every bit as acute as it is in the Highlands. The minimum 50 new training posts that the Scottish Government has announced, which the Royal College of Radiologists welcomes, will certainly improve the situation in the longer term.
I was extremely heartened to see this advice from Nicola Strickland, president of the royal college, to her colleagues:
“Obviously it is crucial that you all start planning immediately where these trainees will be sent, and it might be wise to consider some new rotations especially designed to encourage struggling hospitals to take and nurture trainees in the hope that they will ultimately choose to apply for consultant posts there.”
It is clear from evidence that was given to the Health and Sport Committee that folk who experience Highland life during their training are drawn back there. It is not just me who thinks that the Highlands are a great place to work and live.
That is the long-term solution, but we will also require more creative short-term solutions. One of the reasons why radiologists are such a precious resource is that they take more than a decade to train. I assure members that it takes a lot longer than three years—or five years, which is the figure that Colin Smyth mentioned. These guys are medics first; they do a five-year undergraduate degree, two years of postgraduate foundation training and then five years of specialist training to be radiologists.
It is important to recognise the key role of advanced practitioner and consultant radiographers in imaging departments, but we must also recognise that there are certain tasks that only radiologists can do. Local interim solutions, such as short-term imaging outsourcing and identifying future insourcing capacity using imaging IT networks between hospitals and possibly health boards, could be explored, but those will be options for local management and health boards.
You raise a very interesting point about—
Speak through the chair please, Mr Mountain.
Sorry. The member raises a very interesting point about outsourcing. We currently spend £4.5 million a year on outsourcing, much of which goes on extra payments, and we use private firms to make up the shortfall. The £3 million that the cabinet secretary has put forward therefore seems quite light. Does the member agree that it might be better to increase that figure so that we can reduce the amount of outsourcing we need and do not continue to spend £4.5 million a year?
I have already established that it takes 12 years to train a radiologist. There will not be a quick fix without using outsourcing.
The Royal College of Radiologists suggests that a possible UK-wide solution is to recruit more graduates from abroad to meet our short-term requirements. I do not know how easy that would be, given that, as others have mentioned, the current UK Government is clearly anti-immigration and aims to reduce it.
To begin to take on these challenges, we have to acknowledge that they are complex and that they will require equally complex solutions. They will require Governments to work with groups such as the Royal College of Radiologists, the Society and College of Radiographers, postgraduate deaneries, local health boards and management to achieve a balanced, coherent and sustainable approach to the problem and to ensure that appropriate workforce planning is in place for services across Scotland, particularly in rural areas.17:34
I congratulate and commend my colleague Edward Mountain for bringing the debate to Parliament, and for the excellent work that he is undertaking on behalf of his constituents across the Highlands and Islands to highlight a major concern.
I thank Cancer Research UK for its useful briefing for the debate, and I pay tribute to the outstanding efforts of all the people who work within radiology in Scotland’s NHS.
We should be in no doubt about the seriousness of the situation that we are in as a result of the shortfall in qualified radiologists across Scotland. Earlier this year, the Royal College of Radiologists spoke out in the starkest of terms. Dr Grant Baxter, who is the chairman of the college’s standing Scottish committee, stated:
“Having been a doctor for 34 years I have never seen it as bad as this. Scottish radiology is on the brink of collapse, and if that happens there will be no medical diagnoses or surgical operations at all, since none can occur without radiologists interpreting the scans and X-rays. A perfect storm of increased demand, no significant increase in consultant numbers or trainees, chronically unfilled posts and a tsunami of expected retirements in the next three years means that we need a sustainable solution NOW for the sake of our patients.”
The Scottish Government has known about the situation for 11 years.
We need to get the facts clear here. Since 2007, we have seen a 41.9 per cent increase in the consultant radiologist workforce. Demand has grown and we need more consultants, but it is not true to say that there has not been an expansion.
For my colleague’s constituents across the Highlands and Islands, that response confirms what they are concerned about: this Government is not addressing the issues that the region faces.
Scotland has a much lower proportion of radiologists than the European Union member state average. The latest workforce statistics show a vacancy rate of more than 14 per cent for clinical radiology consultants, which is much higher than the general consultant vacancy rate and almost 10 per cent higher than the rate five years ago.
Almost a fifth of clinical radiology consultants plan to, or will, retire within the next three years, while 36 per cent will retire by 2025. Cancer Research UK warns that NHS Scotland simply does not have the workforce capacity to meet current demand. There can hardly be a clearer example of the Government’s failure in NHS workforce planning.
Radiology is a key part of our cancer diagnostic services, but the pressures on radiology mean that too many patients who were originally referred for suspected cancer are waiting too long for the early diagnosis and subsequent treatment that we all understand and agree are so vital.
The lack of capacity means that significantly more money is being spent on outsourcing, as we have heard, with more X-rays being sent to countries including Australia for analysis. The cabinet secretary will no doubt say that the Scottish Government is committed to increasing the workforce numbers. As my colleague Edward Mountain said, we have welcomed the 50 new training places. I hope that the cabinet secretary will outline how many of those will be Scotland-domiciled.
We do not consider that the Scottish Government’s action will be enough to deal with the crisis at its heart, or that it will meet the ever-increasing demand for imaging services, given that imaging workload increased by 55 per cent between 2010 and 2015.
Kate Forbes mentioned that we need a 10, 20 or 30-year solution. I call on ministers to initiate a comprehensive national review of radiology services that addresses and plans for the needed increase in capacity that our health service faces.
As part of a review, the Scottish Government should work closely with the Royal College of Radiologists and other key stakeholders to take forward their proposals to improve the situation. I hope that the cabinet secretary will commit to a national review when she closes the debate. The issue is too important for sticking-plaster solutions, and patients across Scotland need to have confidence that the Government will put in place a radiology service that is truly world class and meets the needs of our population.17:39
As ever, I am enthusiastic to congratulate all public sector workers, including those at NHS Highland.
Although Mr Mountain told us that the issue is about people and not politics, the last part of his motion says:
“the Scottish Government should match the commitment of ... NHS employees”.
That, to be quite frank, is gratuitous. It is not gratuitous in its own right, but it is gratuitous in that it comes on the back of what I thought was an ill-judged intervention on the issue, when he called for the cabinet secretary’s resignation. That lacked proportionality. It is the nuclear option, and it is indicative of a political mindset, to which I will return.
As a Highlands and Islands MSP, my obligation is clear: I must understand the issues. I am sighted on the NHS Highland paper of 26 September, in which it is quite evident that there is no denial of the scale of the problem. Indeed, the chief executive’s report says that radiology services are currently under “unprecedented” pressure as a result of the shortage of radiologists, and that that is compounded by increasing demands on the service.
We know that several groups of clinicians have expressed concern. I am sighted, too, on the letter that NHS Highland sent to them. One of the calls that the clinicians made was for improved terms and conditions. It has been suggested that there be further dialogue with the Scottish Government; it is clear that that would be a way of helping, so I encourage the cabinet secretary to participate enthusiastically in that. I appreciate that there are shortages all over the place, but there are particular challenges in the Highlands. I am also sighted on NHS Highland’s action plan.
We need to look at everyone’s roles and responsibilities. The Scottish Government has a clear role in ensuring that adequate funding is provided, and I welcome the £3 million that is to be provided. I look forward to Mr Mountain and his colleagues contributing to the debate on taxation, because we need adequate funding. Without that, it will be impossible to fulfil the Tories’ wish list. I have no doubt that what they are asking for today will be the first of many asks from them. We need to understand the funding requirements.
NHS Highland has a requirement to ensure delivery of safe services. That will require a workload assessment, workforce planning and safe staffing levels.
Whether we are in government or in opposition, MSPs have an obligation to articulate constituents’ concerns and to hold to account bodies such as NHS Highland. I have done that in relation to consultations on hospital builds, general practitioner services, nurse practitioners, drug services, waiting times and care at home. The cabinet secretary has received quite a number of representations from me.
There is also the issue of how we conduct ourselves. To represent our constituents and hold bodies to account, we must understand the issues, read the briefings from NHS Highland and attend the briefings that it provides, because there are a number of complex issues involved. That will lead to the potential for some informed comment to be made, instead of the rabble rousing and cheap headlines that we have had.
At this point, I want to talk about the shocking abuse that my colleague Gail Ross has had in relation to health issues in the Highlands. She is not a member of my party, but I know that she works tirelessly on behalf of her constituents and does not deserve the abuse that she has had from the community. In that regard, I must say that I expect a minister of religion to mediate the mob rather than to aggravate or motivate the mob. People need to pay attention to how they respond to their elected representatives and the work that they do.
In the short time that I have left, I turn to Brexit. It will fuel not just the problem of recruitment, but the problem of retention of staff. We already know that there are some people who have had enough and are heading off, which is not a good state of affairs.
I commend the work that is being done to address the problem. We do not need to recount the past; we must deal with the current situation. I urge the Scottish Government to do its very best to put in place a plan that addresses the issue of radiologists not just in the Highlands but elsewhere, and I urge my colleagues not to talk down the Highlands, but to promote it as a place to come to live and work. I say to Mr Mountain that that would be a proper manifestation of people, not politics.17:43
I thank my colleague Edward Mountain for bringing such an important issue to the chamber for debate. I do not think that he is talking down the Highlands in any way—in fact, it sounds to me as though he is sticking up for his constituents in the Highlands, which is exactly what he should be doing.
We all know that the NHS is about people. Without the committed staff our hospitals and surgeries rely on across Scotland, the NHS would be nothing more than an acronym. That is why I feel strongly about the issue that we are discussing and why I wanted to participate in the debate. I would like to provide members with examples of the problem from my region.
West Scotland has had its fair share of difficulties with radiology vacancies. In NHS Ayrshire and Arran, the clinical radiology consultant vacancy rate has reached 34 per cent. To put that into context, the national rate is less than half that level, at 14.1 per cent. To put those statistics another way, that means that there are just 4.5 consultants per 100,000 people in the Ayrshire and Arran area, compared with 5.4 per 100,000 across Scotland.
Those are just numbers but, as I said at the beginning, the NHS is about people, and those people are constituents of mine who have contacted me because they are struggling to get appointments for scans or are waiting far too long for routine scans. Many of those scans are carried out to pick up important concerns that may require further investigation or treatment as serious medical issues.
As other members have mentioned, the spokesman for the Royal College of Radiologists warned in February this year that Scottish radiology could be on the brink of collapse and that the profession faced the perfect storm. The royal college suggested that the Scottish Government should undertake a vigorous recruitment programme in the short term and at the same time begin to produce a long-term planning strategy to increase the number of radiologists who train here in Scotland. It said that both measures needed to start together and without delay. However, one could argue that a long-term strategy on planning should not happen today or tomorrow; it should have happened years ago.
To give credit to the Government, there is a recruitment drive to attract students to radiology, which is welcome. I believe that the west of Scotland radiology training scheme is the largest in Scotland, and it is training a number of students in hospitals in my region, but I would be interested in hearing from the cabinet secretary about the success of that recruitment drive relative to the demand that we know that we face. We have heard about the length of time that it takes to train someone. What will we do in the lengthy interim period while the new students are coming through the system?
Earlier this month, the cabinet secretary told my colleague Mr Mountain that she would be meeting representatives of the Royal College of Radiologists to listen to their concerns. I would find it helpful if, in her response to the debate, she updated the chamber on what actions were agreed at that meeting.
It is clear that the failure to adequately plan our NHS workforce across a wide range of specialisms, not just radiology, is now physically impacting on the quality and quantity of care that is available, but when we bring such issues to the chamber, we always get the same responses, and we have heard them all today. Brexit has been mentioned as something that is somehow a barrier to fixing a problem that the Government was warned about a decade ago.
Will the member give way?
No, I will not. I am short of time.
The second reason that we always hear is that things are just as bad in England. We have heard that again today and we heard it last week. In fact, a week ago, I stood on the front bench to bring up another workforce planning issue, which concerned the lack of GPs in Scotland, and we had exactly the same response from the Government.
The third reason that I have heard today—this is a new one—is that demand has risen. Surprise, surprise. Of course demand has risen. Did we not think 10 years ago that demand for such services would rise? All three of those defences are absolute nonsense, and I am sick and tired of listening to them.
There is no shame in bringing up the issue in the chamber, because the people of Scotland are listening and will expect the cabinet secretary to say exactly what she is doing not just to address the problem in the short term but to ensure that, in another 10 years, whoever is sitting on these benches does not have to have the same debate. I want to go back to my region and tell people that we raised this important issue. We are not scaremongering, and it is absolutely right and proper that we raise such issues in the Parliament.17:48
I thank my colleague Edward Mountain for bringing this matter to a members’ business debate. I have enjoyed the mostly positive contributions of other members in attempting to find solutions and highlight the challenges that we are facing throughout the country. I am particularly pleased to see the cabinet secretary here, as together we must find solutions. I also welcome last week’s Scottish Government announcement on funding and training.
Concerns have recently been raised in my constituency by the medical profession that the problem of a shortage of radiographers is, as we have heard, a considerable issue for the Highlands that is impacting on a wide range of services and on patient care and diagnosis. Radiology is a crucial part of any health service. It provides diagnosis and monitoring to assist on-going treatment. I understand from the Royal College of Radiologists that imaging studies are often going unreported because there are not enough radiologists to interpret them, which means that patients are subjected to increased stress and worry while awaiting results and which could lead to treatment delays.
I firmly believe that, as elected representatives, we must work together to achieve improvements in healthcare locally and throughout Scotland. That is why I was quite disappointed to hear members saying that this is just a Scottish Government problem and to hear no real solutions from other parts of the chamber.
Many of the constituencies that are represented this evening face the same problems with remote and rural healthcare and access to diagnostic services as my colleagues and I face in Highland, and we must insist that our health boards provide a sustainable service, particularly to those in remote and rural areas. We all agree that travelling for hours on end for an out-patient appointment is unacceptable; indeed, travelling for hours on end to attend a diagnostic clinic and then waiting weeks for a radiologist to have time to produce the report is worrying for patients and is creating resentment about how NHS Highland is managed. John Finnie alluded to the particularly difficult situation in Caithness, and I thank him for his kind words.
Like others across the chamber, I pay tribute to all the staff who work in the NHS—some, we will agree, in very difficult circumstances—and I thank them for all their hard work. Scotland’s chief medical officer, Catherine Calderwood, visited Raigmore hospital to discuss the issue and said that new ways of working should be explored to maintain a high-quality service. She said:
“We have to change some of the ways we are working if we are not going to ... have as many doctors as we did have because of recruitment issues.
But there are very good solutions—technological solutions but that also involves the use of other staff ... radiographers who can also report on X-rays.”
There is no point complaining about the issue without looking at alternatives and solutions to the problems that we face. As Kate Forbes said, this is about not just funding but recruitment and retention in the Highlands. As Maree Todd suggested, that cannot happen overnight; after all, it takes more than a decade to train a consultant radiologist. However, I suggest that, by implementing a clear strategy and policy, we can find solutions to the problems of recruiting and retaining permanent skilled staff to cope with the increase in demand in Highland and across Scotland.17:52
I certainly welcome this opportunity to respond on this important topic, and I thank Edward Mountain for raising it. I fully agree with the respect and admiration that have been shown across the chamber for the great work that radiologists carry out and the first-class service delivered by these staff, often in difficult circumstances, to the people of Scotland.
Let me begin by assuring members that we are absolutely committed to a sustainable radiology workforce that continues to provide a high-quality service to the people of Scotland. Before coming to the chamber, I chaired the first meeting of the ministerial cancer performance delivery group, and the key item on the agenda was the national radiology transformation programme. We have reviewed the radiology service and we are now into implementation of the transformational programme, so with all due respect to Miles Briggs, with his call for a review, I point out that we are beyond the review stage and are now implementing the changes that are needed. I will say a little bit more about that programme later.
In the other important item on the ministerial group’s agenda, we heard from NHS Lanarkshire, which is something that I am sure Fulton MacGregor will be interested in. Because of changes that that board has made, it is now the best performing with regard to meeting the cancer targets and we want to roll out what it is doing across the rest of Scotland.
All members across the chamber, no matter what community they represent in this Parliament, are aware of problems with shortages. The review has led to 50 new places, but are they going to be enough in the long term? That question has not, I think, been answered in the review itself. As tonight’s debate has demonstrated, demand is growing. Is the cabinet secretary confident that this will make the difference?
Yes, it will make a huge difference. I point out that we keep the numbers required in every specialty under review—of course we do—but, as I have said, I think this will make a huge difference. I will say a little more about the detail of that in a minute.
I first want to emphasise the considerable commitment that is shown, day in and day out, not only by radiologists and their staff but by those in the many other medical specialties and professions in our NHS. I certainly agree with the motion that it is essential that we match that commitment through the steps that we are putting in place to improve the way in which services are delivered and workforce planning that reflects that.
It is important that we put the progress that we are making on radiology in the context of the work to implement part 1 of the “National Health and Social Care Workforce Plan”, which was published in June this year. That is a key part of our delivery plan and it demonstrates our commitment to a sustainable workforce that continues to provide a consistently high-quality healthcare service. The steps that we are taking through the plan will help us to improve the data that we have; develop our knowledge of the effects of different supply and demand factors; and enhance our ability to recruit and retain the staff that we need at national, regional and local levels, while constantly keeping that under review.
We have seen significant expansion in the number of radiology consultants in recent years and we have implemented considerable increases in the radiology training establishment. However, as Kate Forbes pointed out, there are particular challenges in recruiting to posts in rural areas, and we are far from complacent. We recognise that there has been a marked increase in demand for the diagnostic services that are provided by radiology and we recognise how vital those services are in underpinning the wider healthcare system.
We are already working closely with NHS Highland to support improved performance of its radiology service, and we are taking forward a comprehensive range of actions to address the issues that we have discussed today. In August, the Scottish Government access support team carried out a review of NHS Highland’s radiology service to support improved performance and sustainability. As a result, work is already in hand to address immediate radiology staffing priorities. Steps are being taken to ensure that there is capacity to accommodate demand, including the development of an evidence-based staffing model to support the radiology service in NHS Highland in future. I have also asked NHS Education for Scotland to look at the distribution of radiology trainees in the north region to ensure maximum value and optimal utilisation of the training potential in the board. That will of course apply to the new training posts that I have announced.
At the moment, there are 7.8 radiologists in the Highland region, despite a requirement six years ago for 13. The radiologists estimate that, to ensure that all the scans are read on time, 20 radiologists are needed. Is that the figure that the cabinet secretary is working on for NHS Highland?
That is why the work of NHS Education for Scotland is so important. We need to make sure that the distribution of trainees is right and that the establishment, in terms of the number of posts, is right. That work is absolutely essential.
On 21 September, I held a helpful and productive meeting with the Royal College of Radiologists to discuss the issues. Edward Mountain might want to listen to this, because it is important. We agreed a number of areas on which we can work constructively together to address a range of points that have been raised in relation to NHS Highland and wider radiology staffing. I also welcomed the college’s offer to support clinical leadership with consultants in NHS Highland and more widely in the north of Scotland with the aim of maximising recruitment potential, and its offer to develop effective cross-board regional working for radiology. I will meet with the college again in the coming months to discuss progress on those matters.
There is also potential to strengthen the multidisciplinary team approach and to make full use of reporting radiographers to enhance capacity and productivity across the service. I can confirm that NHS Highland is currently training additional reporting radiographers and that work is already under way to increase the reporting radiographer capacity across Scotland.
Nationally, we have enhanced the supply of doctors to fill radiology training posts, with 26 new training places over the past four years, which is an increase of 20 per cent. That is in addition to the significant expansion in the existing consultant radiology workforce, which has increased by more than 40 per cent since 2007.
We have established a national radiology implementation programme, supported by NHS boards, which aims to develop the longer-term vision for radiology and to reduce demand on services. I can confirm that the Royal College of Radiologists has kindly accepted my invitation to it to take up a place on the programme board so that it can contribute its valuable perspective and experience to that work.
On 26 September, I announced an additional £3 million to increase the number of radiology trainees in Scotland by at least 50 over the next five years, and I am pleased that members across the chamber have welcomed that. The announcement was made in the context of our wider package of measures to improve waiting times for diagnosis and treatment of cancer patients in Scotland. I am pleased to note that the Royal College of Radiologists welcomed the announcement and acknowledged that the additional training posts reflect our long-term commitment to enhance the radiology workforce. The college’s president said that it is
“a much needed step in the right direction to address this problem, and help safeguard the health of the Scottish nation.”
I look forward to working closely with the college and NHS boards as we take forward this important range of initiatives to further strengthen the radiology workforce. I am confident that they will make a real difference and help to address the many important issues that have been raised in the Parliament this evening.Meeting closed at 18:00.