 Mae'r ystafell, wrth yr oedden yn hynny'n cymryd â'u cwestiynau perffolio'r ystafell, wedi'i yw'r gilydd? Thank you very much. To ask the Scottish Government how the spending proposals in its draft budget will help to achieve woodland planting targets. Minister Gillian Martin. Thank you Presiding Officer. The draft budget will support over nine thousand hectares of new woodland in Scotland, which will be more woodland creation than the rest of the UK combined. We are engaging with stakeholders so we can maximise tree planting and the of the benefits for climate, the economy, people and nature? Criam Simpson. I thank the minister for that answer, but what she neglected to say, of course, is that the Scottish Government has a target of planting 18,000 hectares of trees in a year. They are now providing funding for half that. The actual answer to the question is that the draft budget will not achieve the woodland planting targets. That was the answer she was searching for. Can I ask her this? If Scottish forestry's woodland grants budget is going to remain lower after 24 or 25, which it will, how will resources be split between native woodland creation, commercial forestation, agro forestry and trees outside woods when there is not enough to fund more than 9,000 hectares? I am glad that Criam Simpson has given me this opportunity to respond to what he said about the fact that there was an 18,000 hectare target. Of course there was, but we do not want to be in this situation. The UK Government has reduced capital allocation to the Scottish Government of 10 per cent. I do not know how good Mr Simpson's arithmetic is, but when your thorac landing is slashed to the bone, as it has been, and the autumn statement is as disappointing from the perspective of the Scottish Government as this one was, a Government that is devolved needs to make very difficult decisions on what and where you can spend what you have. It seems to me that, on so many occasions, the Tories are content to shout about targets, even vote for the setting of targets from time to time, but when it comes to advocating for the UK Government to uphold its responsibility in allocating adequate funds to devolve nations to allow us to fulfil our obligations, they are completely silent. Scotland is creating the most woodland in the UK and will continue to do so, despite the Tory savage in our budget by cutting the capital allocation. Does the minister share my view that, if that is what we can hope to achieve in the current fiscal nightmare, there would be no limit to what the forestry sector could achieve if the Tories here put Scotland first and took a stand against the 10 per cent cuts to our budget? It is a fiscal nightmare. We have been working closely with forestry stakeholders to increase confidence and grow capacity to deliver woodland creation in Scotland for many years. As a result, during 2023, we have seen record levels of woodland creation projects and development, both native and productive conifer schemes. We are encouraging applicants to turn that into successful planting to utilise all the available budget that we have this year that would put us back on track for 2023 to be a record year. However, the potential is greater for 2024. Unfortunately, as Emma Harper points out, the reduced funding from Westminster Tory Government means that it will be challenging. To ask the Scottish Government whether there is any scope in its proposed land reform legislation to amend the power of the Kings and Lord Treasurer's Remembranser, known as the KLTR. The Kings and Lord Treasurer's Remembranser is the Crown's representative in Scotland with the authority to deal with ownerless property. Any surplus funding from the KLTR is passed to the Scottish Government as a contribution to the Scottish Consolidated Fund and the KLTRs derive from the Scottish common law. They do not involve any exercise of any executive power or control by the King. Given the KLTR's previous current and future contributions to the Scottish public purse and its clear alignment with Government priorities, there are no plans to amend his current powers in the land reform bill. I am pleased that any money's release from such assets go to support essential public services. Would the minister agree with me that often communities can be blighted by derelict and vacant land and assets that would fall to the KLTR? How can we ensure that communities might also benefit from such assets and their value in the future? I thank Rona Mackay for that supplementary question and for her continued interest in this issue about vacant and derelict land. In addition to the annual contribution to public funds, the KLTR is about to launch the ownerless property transfer scheme. I can confirm today that the date for this launch is 1 March 2024. The scheme will create new opportunities for public bodies, local authorities and community organisations across Scotland to acquire ownerless property. It will help them to return local land and buildings, including abandoned and neglected property, to productive use for the benefit of local communities. It has been carefully designed with key stakeholders to ensure that properties are used and developed sustainably and in the public interest. To ask the Scottish Government whether fishing in the Firth of Clyde will be suspended in 2024 in line with the cod spawning season. Following consideration of the Firth of Clyde closure, which was implemented for 2022 and 2023, and the responses to the public consultation carried out between June and September last year, I consider it appropriate to continue the spawning closure in the same manner without exemptions for the 2024 and 2025 period. This decision is based on the best available scientific evidence, which shows that any activity within 10 metres of the seabed has the potential to impact on cod spawning activity. I thank the minister for that answer. I wonder if the minister could tell me when a full business and regulatory impact assessment will be published and will she consider, I know she said she wouldn't consider the exemptions, but would she consider exemptions from net for trawlers, creals and scallop digers? I thank Annie Wells for that question. We are obviously working very hard with the available data that we have on the Clyde to make decisions of this matter. We are under no absolutely no illusion that a 10-week closure of particular areas of the Firth of Clyde is inconvenient and could be potentially costly for some vessels. However, what we do know is that those vessels can fish in other parts of the Clyde for this 10-week period. What we are effectively doing here is talking about a 10-week period to prevent disruption to cod spawning. In those 10 weeks, vessels can fish in other waters. The closure only affects two areas in the Firth of the Clyde, and this has been done to improve fish stocks, which we hope will mean that their fishing in the future is more sustainable. Minister's letter to the Rural Affairs and Islands Committee on January 11 stated that we have reviewed the available scientific evidence to reassure ourselves that this approach is the most appropriate and proportionate. Can the minister set out the evidence base that guided the Scottish Government to the decision? It is best available evidence. I know that it creates challenges for local fishermen, but the marine director that is currently reviewing its scientific observer programme with a view to enhancing data from the Clyde working with the Clyde Fishermen's Association. Work with our coastal state partners will begin this year to review the management measures in place across the Northern Shelf Cod stock. That will provide a comprehensive route for managing Northern Shelf Cod and the north-western sub-stock, which includes Clyde Cod. To ask the Scottish Government what assessment it has made of the impact of its 2024-25 budget on rural and island communities. The budget has delivered very difficult and required very difficult choices due to the pressures on our public services and the lack of funding from the UK Government. Despite that, the Scottish Government will invest over £1 billion in 2024-25 in the rural affairs land reform and islands budget. While the budget sets the spending envelopes, cabinet secretaries across the Scottish Government will develop and deliver programmes in those budgets and my officials and those of the cabinet secretary are supporting colleagues in assessing impacts on communities as more detailed plans are developed, including in relation to requirements of the island Scotland act. Pam Gossum. I thank the minister for that response. The costs of delivering services are significantly higher in the islands and significantly vary between different island communities. The Scottish Government ministers and the COSLA committee to review the special islands needs allowance. Sina has not been adjusted for a number of years now. Can I ask the minister for her views on a potential review of Sina and whether she believes that the current settlement is truly delivering for our island communities who depend on that support? I am happy that she will appreciate that the cabinet secretary is not here today. I will pass back the specific asks about the review of Sina. We were able to secure capital funding of £3 million to support implementation of the national islands plan, in addition to the £12 million over the past three years. That has already delivered a new nursery in Orkney, a refurbishment of community facilities in Papastore, and provision of workers' accommodations in Mull. Do not forget the local government settlement for 2024-25, which will provide island authorities with £1.5 billion. That is an increase of £74.7 million from the previous year. Cabinet Secretary Neil Gray met me, the chief executive of North Ayrshire Council, on representatives of Arran's hospitality sector on 29 November, to discuss their concerns. I am delighted that Mr Gray not only listened but in the Scottish budget island hospitality businesses will now receive 100 per cent relief on the rates on a rateable value of up to £110,000. Can the minister advise what the impact of the additional assistance will be on island hospitality businesses? The 100 per cent non-domestic rates relief for properties in the hospitality sector on islands, capped at £110,000 per rate pair, is expected to be worth over £4 million in the next financial year, and shows that the Government values and supports island communities, which is, of course, in stark contrast to the Westminster Government that pursued a hard Brexit, which resulted in adverse impacts on island economies in general and hospitality businesses all over Scotland, in particular, through the creation of new barriers to trade, increased costs and, especially, the loss of freedom of movement, resulting in exacerbating labour shortages. Last week, in the chamber, we debated the Scottish rural islands and youth Parliament. Young people are calling for sustainable transport, food and a more compassionate politics. Is the Scottish Government confident that its budget is sufficient to invest in the futures of young people in rural and island areas? Well, if Beatrice Wishart will forgive me for maybe putting my other hat on for the moment, I was actually in Orkney a couple of weeks ago, and I'm planning on visiting in Shetland, to look at how we can maximise the employment opportunities for young people, particularly through renewables. The Scotland developments give massive opportunities for island communities, particularly in the northern isles, for young people. We have all heard for many, many years now that there is often that young people go to college and university in the mainland and they find it difficult to get the jobs that they are qualified for to come back to, when they would like to come back to the islands. I'm hoping that that energy revolution that we are steering through will help in that respect. Mr Halker-Johnston, I would appreciate if we don't get a running commentary from the front bench. Question 5, Jackie Dunbar. To ask the Scottish Government in light of reported concerns regarding food labelling being a devolved matter, what discussions it has had with the UK Government regarding the potential impact on Scotland's food and drink sector of the reported proposal for not for EU labelling on food and drink products in the UK. As the First Minister noted in his answer last week, we share the well-documented concerns that Food and Drink Federation Scotland do and many food and drink businesses. They have highlighted many concerns about those labelling plans. Extending the labelling requirement risks arbitrarily putting additional costs on Scottish businesses when we are already facing a cost of living crisis and increasing food costs. Ms Gougeon wrote to the Secretary of State for the Environment, Food and Rural Affairs before Christmas to ask for some much-needed clarification on their plans but, unfortunately, she is yet to receive a response. Jackie Dunbar. I thank the minister for that answer. A range of food and drink producers have voiced concerns that additional labelling may add bureaucracy and put off consumers. If Scottish businesses are saying not for you is not for us, how will the cabinet secretary advocate for them to the UK Government? I am sure that, if people knew that taking back control meant adding more red tape, they might not have voted for Brexit. The food and drink sector has undoubtedly borne the brunt of the UK Government's hard Brexit, which has disrupted supply chains over the years since it happened, created new barriers to trade and driven up overall food prices. We are all playing a very high price for a Brexit that Scotland did not vote for. The Cabinet Secretary for Rural Affairs, Land Reform and Islands has written repeatedly to the UK Government on a range of issues around this to urge it to address these arising from Brexit, where it holds the levers to do so. The not-for-EU Labour will support retailers and supermarkets to move food and drink products between Great Britain and Northern Ireland as smoothly as possible, and it means that suppliers will not have to establish different production lines to be able to sell those goods in Great Britain and Northern Ireland. Ensuring that those products stay on the shelves and consume the choice is maintained. Cabinet Secretary, despite the grievance that you are talking about, can you welcome the move, which is good for shoppers and good for farmers? I thank Rachel Hamilton for that party political broadcast, indeed for the promotion that she gave me there. What I would do is to quote back to her, the Food and Drink Federation director for growth, Bill Winder Doot, said that—this is a quote from him— "...our members are really clear that the Government's plan to extend not-for-EU product labelling on a UK-wide basis will hamper growth, hit investment, exports and jobs while increasing consumer prices and restricting the choice of products." That is the sector saying that, not me. Question 6, Michelle Thomson. To ask the Scottish Government what its most recent assessment is of the potential impact of the border target operating model on rural affairs in Scotland. The Scottish Government agreed to adopt the UK Government's new model in order to bring the much-needed biosecurity controls on imported goods. We continue to have a number of outstanding concerns and are working with the UK Government on addressing those. We urge the UK Government to pragmatically align its standards with the EU and sign a comprehensive veterinary agreement, which would lessen the need for many of those controls. The Scottish Government remains clear in its view that the best trading relationship for Scotland would be found as a EU member state. I thank the minister for that response and she will be aware that Grangemouth is in my constituency and is the biggest export port hub in the country. I am personally concerned about the potential impact of the border target operating model. To what extent the Scottish Government is content that Grangemouth specifically and indeed other Scottish ports and exporters have all the specific details that they need to handle those import controls when they are introduced? I thank the cabinet secretary and share the concerns of Michelle Thomson on that. The flat answer to it is that they do not have the necessary information at the moment. We have spent considerable time and effort during the development of BTOM to balance Scotland's biosecurity trade interests and ensure that all stakeholders that trade with and from Scotland have the clarity that they need to adopt to post-Brexit trading. Regrettably, the UK Government has not engaged with us as it has promised to be signed in August and we have yet to have any kind of engagement or clarity. There are an awful lot of areas requiring further detail and that is the feedback that we are also getting from those who work in our ports. The new provisions largely address imports in the EU, so they are a step towards leveling the playing field. However, our exporters have had to cope with the EU's own import controls for the last four years, whereas importers have faced minimal checks and burdens. To ask the Scottish Government what financial support will be made available to farmers in 2024-25. The Scottish Government will invest over £1 billion in 2024-25 in the Rural Affairs, Land Reform and Islands budget. We will continue to provide Scotland's farmers, crofters and land managers with the most generous package of direct support in the UK. That is worth over £600 million. That is despite an autumn statement that falls far short of what we need and has delivered a cut to the capital allocation by over 10 per cent and a real-terms reduction in the total block grant. In just two years, the common agricultural scheme will have ended and the agricultural sector faces a very uncertain future about what will happen. I suspect that they do not feel that there has been much investment in their sector. Can the minister explain the decision-making process that is taken by the cabinet secretary? There is cut or frozen funding for key agricultural schemes such as Pillar 1 payments, the agricultural reform programme and the less-favoured area support scheme, at a time when farmers and crofters are already under severe pressure? Yes, farmers and crofters are under severe pressure. That has not helped by exiting the EU. One thing about the common agricultural policy is that it gave certainty of multi-year funding. It is worth mentioning that, in addition to the direct payments that we will give to farmers and crofters, there are payments that are not available to farmers in the other UK nations. We give, for example, £48 million of voluntary couple support for beef and lamb producers and £2.7 million for fruit and vegetable aid schemes. Sue Webber will also not want me to go into detail all the other funding streams that rural Scotland has lost as a result of her party taking us out of the EU. A Brexit that Scotland did not vote for, the Republic of Ireland, I was looking at the Republic of Ireland, they have received an allocation of £180 million of leader funding, incidentally. I will not take any lessons from the Tories on how we support our farmers. We are doing what we can with what we have, but, unfortunately, the UK Government taking us out of the EU has made that extremely difficult. Thank you. We have got a number of supplementaries that they will need to be brief, as will the responses first, to unfairly. Thank you, Presiding Officer. I am very glad that the minister touched on it, but I will never tire or apologise for repeating this direct payments. The SNP-led Scottish Government is paying farmers to farm and produce food, and that is the single most important support element that could be made available. I wonder whether the cabinet secretary shares my bewildering that the party, which is so desperate to cast itself as the farmer's champion, has not lifted a finger to try and get clarity from its colleagues in Westminster about what the quantum of funding for Scotland's farmers can expect from 2025 onwards? I agree with Jim Fairlie, and I share his probable anger on this. There is no funding commitment from 2025. We need clarity and certainty from the UK Government about future rural funding after 2025. Farmers need to plan, and they need to know what it is that they are going to be getting. The UK Government, as I have mentioned, only provides yearly allocations that do not adequately replace EU funding, and that EU cap provided that multi-annual programme budget over the seven-year period. Mary Gusion has made repeated requests to UK ministers to engage in this, including several letters to Steve Barclay since his appointment, but they still wait in their response. The agriculture is devolved, and it is crucial that Scottish Government policies are unhindered by the threats posed by the UK Internal Market Act, subsidy control regime, and the lack of long-term replacement of EU funding. I will get one more supplementary in, but I will have to ask the Tory Benches again to desist from heckling throughout the course of answers being given. I will call Rhoda Grant. The Scottish Government still owes Scottish farmers £46 million. Why are they cutting the budget for agriculture when they still owe that amount of money? As Rhoda Grant will see, I am not Mary Gusion, and she is in charge of the budget allocations for that, but the fact that Rhoda Grant has raised it in the chamber means that she will want the record, and I will certainly pass that back to her, and I will get her to write to her. To ask the Scottish Government what assessment it has made of the importance of the salmon industry for Scotland's economy. Thank you. Scotland's salmon industry is a significant contributor to our economy. The Scottish Government's annual marine economic statistics and our fish farm production surveys show this. In 2021, agriculture generated £472 million. 96 per cent of that was from the salmon industry, and in 2022, salmon farming achieved a record value of over £1.2 billion. As the Scottish Government commissioned a report in 2018 examining agriculture's wider economic impacts, it showed that the sector supported 11,700 jobs and generated £885 million of GVA. Our vision for sustainable agriculture sets out our ambition to grow the sector and makes clear our support for the sustainable industry. I thank the minister for her answer, and I would say that given the very significant sums that are involved in GVA and the extremely high number of jobs that are supported by the salmon industry in Scotland that the minister referred to, including 600 jobs at Maui in recithes in my constituency of Couturebeath, can the minister advise as to when we can expect to see progress on fully implementing the Greg's review recommendations that were put forward nearly two years ago? I thank Annabelle Ewing for that, and I am pleased to pass on that the cabinet secretary is content with the progress that has been made since receiving the ambitious recommendations in the independent review. Last July, she published the vision for sustainable agriculture and progress has been made on the consenting recommendations, with the development of a pilot proposal for a new pre-application process for fin fish farm applications. The cabinet secretary looks forward to working with stakeholders to further consider the recommendations of the Scottish Science Advisory Council. She hopes that, in making progress, allowing sensible time for due diligence and collaboration with Scottish Aquaculture Council and others, that we are able to implement the best possible solutions. We often hear about the economic benefit for Scotland from salmon farming, despite the vast majority of profits going to foreign-owned multinationals. Has the Scottish Government assessed the cost of the environmental damage caused by the industry, including damage to blue-carbon sites, precious fish nurseries commercial, fish healthy stocks and our iconic wild Scottish salmon? I do not recognise the picture that Ariane Burgess paints of Scotland's agriculture sector. All fish farms in Scotland have to meet strict environmental guidelines. Potential environmental impacts of farms are considered in planning applications by local authorities and advised by a range of statutory consultees, and SEPA also monitors the environmental impacts of all fish farms, with no exceptions to ensure safe management. As Ariane Burgess will know, the reason for the decline in wild salmon stocks is that they are wide-ranging and extremely complex, and we take that decline very seriously and are working to ensure the protection and recovery of the iconic species. That concludes portfolio questions on rural affairs, land reform and islands. It is time to move on to the next portfolio, which is NHS recovery, health and social care. Again, any member is wishing to ask a supplementary question. She pressed the question-spreak buttons during the relevant questions. Again, there is a lot of interest in this, so the usual appeal for brevity in questions and responses. Question number one is not lodged. Question number two, Brian Whittle. Thank you, Deputy Presiding Officer. To ask the Scottish Government in light of announcements made in its budget, what action it is taking to ensure that well-established community mental health services are appropriately funded. We continue to invest in quality community health services to support our prevention and early intervention priorities. That includes investment of more than £2.1 billion for primary care and supporting spending in excess of £1.3 billion for mental health. That will continue to enable record numbers of mental health staff providing more varied support and services. The mental health and wellbeing delivery plan commits to improving mental health service provision in primary care settings with a focus on prevention and early intervention in the community. That will include the development of multidisciplinary teams in general practice, maximising the role of community mental health teams, digital provision and NHS24 to make access simpler and quicker. Brian Whittle. I thank the minister for that response, but the Morphin Day Centre in Kilmarnock, which has been supporting people with learning difficulties in mental health issues for over three decades, has now had its funding withdrawn by the local health and social care partnership. The decision has been described as devastating by those who use the centre and will almost certainly to add pressure on local social services and the NHS as people who would otherwise have gone to Morphin Day services or forced to seek services elsewhere. Does the minister agree with me that closing established community mental health services like Morphin Day Centre to achieve short-term budget savings is exactly the opposite of the approach that we should be taking with mental health in Scotland? Will she commit to exploring whether any alternative sources of funding are available through the Scottish Government agencies to protect services like the Morphin Day Centre? I will agree with the member that investment in social care makes a profound difference to people's lives and it is vitally important that we maintain services for people with learning disabilities based in communities. However, there is a requirement for local health and social care partnerships and local democratically accountable organisations like the local government to be locally accountable for decisions to set priorities to understand the landscape that occurs in their local area and to procure services to meet the needs of their population. It would not be appropriate for me, as a Government minister, to intervene in those processes, but I absolutely recognise the importance of good high-quality social care in transforming people's lives. Whilst it is appropriate for local services to be decided locally, the minister cannot aggregate a responsibility for cutting the resources available to allow those decisions to be made for the best interests of those communities. In 2022-23, the community's mental health and wellbeing fund was oversubscribed with almost half of all applicants missing out. Does the Scottish Government accept that more support is needed for these community-based mental health services? What assessment has it made of the insufficient capacity of the community's mental health and wellbeing fund to meet the huge demand from local authorities and local health and social care partnerships? How is it helping to support the high number of unsuccessful applicants because those services failing is surely going to cause a long-term concern? There are a number of different ways that we invest in local communities, both through local authorities and through the third sector interface fund directly to support mental health organisations and to have a mental health impact in our communities. The Scottish Government is absolutely committed to delivering high-quality services, but we are in an extremely difficult and to supporting households, but we are in an extremely difficult financial situation at the moment. The financial pressures right across health and social care are by far the most challenging since devolutions because of rising inflation and the on-going impact of Covid and Brexit. We are making really difficult decisions to balance the budget. We are prioritising spending to support services and to make a record pay offer to our NHS staff and to support them through the cost of living crisis and to avoid industrial action. We will absolutely maintain our focus on progressing those key commitments to support mental health. I have worked really hard to maintain spending and to protect mental health funding from the situation that we find ourselves. Thank you, Minister. We are going to have to move on. Can I ask that supplementary questions are indeed a question rather than a question in four parts? Briefly, Beatrice Wishart. Thank you, Presiding Officer. The pandemic highlighted the mental health crisis in Scotland and the impact on young people who are showing high levels of mental health. The Scottish Rural and Islands Youth Parliament wants to see service improvements with interventions including the creation of social support places and solutions tailored to specific age groups. With a £30 million budget cut by the Scottish Government, is it really committed to improving mental health services for young people? We are absolutely committed to improving mental health services for young people and it was a delight for me to meet with those young parliamentarians here in this building just last week. We have made massive and sustainable improvements in our CAMHS investment. The waiting lists are falling. The median time to be seen is now 10 weeks, so one and two children who are referred into CAMHS are seen within 10 weeks, and 13 out of 14 of our territorial boards have all but eliminated long waits. I agree that progress needs to be made, but you can see by our track record of progress that progress is being made. Thank you, Presiding Officer. To ask the Scottish Government what action it is taking to support people with diabetes. The Scottish Government is committed to ensuring that everyone living with diabetes can access clinically appropriate, safe and effective person-centred healthcare treatment and support. In February 2021, we published a refresh of the diabetes improvement plan that sets out our aims and priorities to support those living with diabetes. The implementation of the plan is overseen by the Scottish Diabetes Group with multiple well-established projects running, including improving diabetes education, prevention of foot ulceration in patient care and supporting people with diabetes during and after pregnancy. A major focus of the plan is to increase access to diabetes technologies. Since 2021, the Scottish Government has invested over £19 million additional funding to support that commitment. I thank the minister for that answer. Many constituents in Glasgow have contacted me about the worryingly long periods of time they are waiting for insulin pumps, with some people waiting over 12 months. When will the Government's plan on technologies to support people with diabetes be rolled out? What can it do to help my constituents to get the diabetes technologies that they need in the meantime? As I said in my original answer, we have increased the level of funding on that. Between 2016 and 2021, the Scottish Government invested £10 million of additional funding specifically to support the increased provision of insulin pumps and continuous glucose monitors. Between March 2021 and 2022, a further £19.6 million was allocated to NHS boards to support increased access to diabetes technologies, including closed-loop systems. In November this year, the Scottish Government provided 1.5 million additional support via the outcomes framework for insulin pumps and diabetes technologies. It is really important to note that the funding is in addition to and not a replacement for local budgets. Baseline funding is provided to NHS boards, and they are expected to continue funding provision locally to meet patients' needs. We also work very closely with the diabetes managed clinical networks within each board to identify and resolve any issues that are raised, such as the ones that Pam Duncan Glancy raises in Glasgow regarding the access to diabetes technologies to ensure that resources are targeted to support the needs of the local populations. We absolutely recognise that there are significant challenges for NHS services. Thank you, minister. I am going to take a couple of British supplementaries first, Emma Harper. Thank you, Presiding Officer. As we know, diabetes technology can significantly enhance people's quality of life. I remind members that I have type 1 diabetes, and I am a tech and pump user. However, there is a disparity in the availability of diabetes tech between the different health boards in Scotland. Can the minister comment on how the Scottish Government is supporting health boards to deliver diabetes tech to those who would benefit from it? I will take a very quick moment to recognise Emma Harper's on-going interest in this area and her use of our own experience to highlight the issue to our population. As I said, we have invested in 19.6 million of additional funding specifically to support the increased provision of diabetes technologies, but we recognise that significant challenges remain. It is really difficult for NHS boards to provide technology to everyone who would benefit with the, in their current models of care and variation, exist. We work really closely with the diabetes management clinical networks within each board to identify and resolve any of those issues. Just recently, we have commissioned the development of a national on-boarding team. That pilot will provide dedicated support to NHS boards and roll out technology faster and more efficiently. A key focus of that project is reducing regional variation and making that technology more equitable access across Scotland. The question of interest is a practicing NHS GP. Yesterday, a parliamentary inquiry chaired by former PM Theresa May published its report into Type 1 diabetes and distorted eating in England. The former PM also shared her personal experience of living with Type 1 diabetes, which is echoed by similar stories that I have heard from reports published by Diabetes Scotland. Can the minister provide clarity on what plans the Scottish Government and NHS Scotland have for the treatment of Type 1 disordered eating? We absolutely recognise the link between mental health and disordered eating and Type 1 diabetes. We have a significant investment in the link between mental health and diabetes. That report by Theresa May is really important. It is absolutely to be commended that she has used her own experience to highlight this really vitally important area. We, as a Government, will be keen to look at that report and see what we can learn from it. To ask the Scottish Government what assessment it has made of the 4th Valley University College NHS partnerships impact on the delivery of health services in 4th Valley. The partnership that was launched in October 2022 is the first formal regional partnership between the health board, university and college and an exemplar of cross-public sector engagement amongst anchor institutions in Scotland. Focusing on learning, career development, research and innovation, we are interested in its progress, which includes the January 2024 launch of a fast-track nursing course at 4th Valley College to widen access to the undergraduate nursing programme at the University of Stirling and supporting new employability placement opportunities in local health services. We recognise that the strong links have the potential to drive forward research and innovation, to improve health outcomes and improve attraction into health careers locally. We continue to engage with NHS 4th Valley and its partners to understand the on-going impact of this new partnership on service delivery. Is the partnership model 1 that the Scottish Government would encourage other health boards and education establishments to replicate? I certainly want to encourage other partners to consider it. I should put on record my congratulations to the 4th Valley University College NHS partnership and the approach that they are taking in working collaboratively together. As a Government, we would like to encourage other local partners to look closely at the approach that is being taken in 4th Valley as it provides an opportunity to drive innovation and to support service delivery improvement going forward. Learning is critical to attract future NHS workforce to ensure that they have the skills and experience to ensure that they help to healthcare. Recruitment and retention are clearly issues for NHS 4th Valley. Therefore, what actions has the Scottish Government taken to ensure that the most experienced candidates are attracted to drive forward innovation, improvement and health and wellbeing? A range of work that we are taking forward on all to attract people into our healthcare professions, including the NHS and Midwifery task force, is looking at a whole range of areas that we can do to help to encourage people into areas such as nursing and midwifery. That involves a whole range of stakeholders from our higher and further education institutions, our regulatory bodies, the trade unions and our NHS boards, all working collaboratively to identify the key measures that we can take, not to address the very issue that Alexander Stewart mentioned. What action is it taking to support and improve the network of community hospitals? The Scottish Government is committed to supporting everyone in Scotland that receives the very best health and social care in the most appropriate setting. That includes community hospitals, which form a vital part of the health and social care system. Community hospitals are managed by either IJBs or NHS boards who consider how best to support people to move from acute hospitals and receive intermediate care where it is not yet appropriate to receive this care at home. To support that work, a national community hospital group has been established to link professionals, seek assurance and share best practice on efforts to support system flow in and out of community hospital settings. I am pleased to hear that the cabinet secretary agrees with me that the patients and families should rightly expect to have health and social care services available as close to home as possible, whether that is in an urban or rural setting. I have highlighted the critical role of Scottish hospitals with the health secretary on numerous occasions, because it is hugely important that it is stepped down care, pallative care and other treatments are offered locally by dedicated health professionals. Scottish hospitals have previously provided such services and two of them remain closed. Does the cabinet secretary agree with me that it is totally unacceptable that there are no clear plans for their future and what can he do to ensure that those facilities and the services that they deliver are as close to home as possible? Community hospitals are an essential part of our health and social care system and they provide a wide range of local outpatient and inpatient services from mental health, pallative, end-of-life care and through-to-rehabilitation, minor injuries, outpatient clinics and, in some cases, access to diagnostic services. It is important that those services are delivered at a local level. I am aware of the issue that the member has raised. I wrote to him in this matter back in November of last year and I understand that the local health board is taking forward some work in considering the use of community hospitals in that area. I encourage the board to continue to make sure that they remain engaged with the local community and how best to deliver and design those services. Previous research into community hospitals in Scotland found that, despite the range of primary and specialist care services offered at the community hospitals, staff and management in both settings felt that the potential for local provision had not yet been fully realised. Can I ask the cabinet secretary what specific work the Scottish Government is undertaking to ensure that our highly valuable community hospitals are actually realising that full potential in delivering for local people? As I mentioned, we have established a national community hospital group that has been established in order to provide a link between professionals and to seek assurance and to share best practice in an effort to support the system more effectively To ask the Scottish Government whether it plans to take any action on any concerns that it may have regarding the 2018 GP contracts in relation to rural practices. The Scottish Government established a remote and rural working group chaired by Professor Lewis Ritchie in response to the concerns of rural GPs about the 2018 contract. The group that produced the shaping the future together report in January 2020 and various actions have been undertaken as a result. The 2018 GP contract is based on allowing GPs to focus on their expert medical generalist role by funding health boards employed at multidisciplinary teams. Health boards and health and social care partnerships and GPs should work together to ensure that the transfer of services meets the needs of local patients. It is clear that the 2018 contract has not worked for rural practices and is now being compounded by NHS Highland with drawing funding for the GP enhanced services. Will the Scottish Government address this with NHS Highland as clearly it further impacts GPs' ability to provide a service for conditions such as diabetes and alcohol misused to mention, but too? I recognise that there are some challenges around the GP contract in rural areas, which is why we established a group under Salou's Ritchie in order to look at some of those issues. There are measures that have been taken forward in order to address that. For example, through the creation of our rural health centre, we have work that we are taking forward with a particular focus on primary care in rural areas in order to look at what further actions can be taken in order to help to support and sustain them. In relation to the specific matters relating to NHS Highland, I would certainly want to make sure that the board is looking at making any changes that they fully engage with health local GP practices in order to make sure that they are properly consulted on any potential changes that have been implemented. Can the cabinet secretary provide any update regarding the national centre for remote and rural health and care and how it will support the sustainability and capacity of primary care in rural communities? The national centre for remote and rural health and care was launched in October last year and has been delivered by NHS education for Scotland. The centre will work with health boards and health and social care partnerships to improve improvements in sustainability and the capability of remote and rural and island primary and community care services, avoiding an approach that is a one-size-fit-all approach. A programme of rural specific training sessions is in development and two pieces of work are already progressing, focused on improved support and training for remote and rural dispensing practices and developing supervisory training hubs. Cabinet secretary, what he has to say to people, patients whose multidisciplinary teams can be 60 miles away, it actually worsens health inequalities and indeed those facing the bigger barriers find it more difficult to travel to centralised locations? I recognise in rural areas that there can be challenges in terms of the remoteness of some of the service delivery. It is important that boards, when they are establishing and taking forward the planning for the multidisciplinary teams in primary care, make sure that they try to address those as effectively as possible by making them as close to patients as possible. Understanding some circumstances that may not always be possible, but it is important where it can be achieved that they do so. I ask the Scottish Government whether it will provide an update on the support that is available for people living with or affected by dementia. As detailed in our new dementia strategy for Scotland, which launched in May last year, we are committed to improving the experiences of our dementia communities. That includes through our investment in dementia care and support by health and social care partnerships of £2.2 billion in 2022-23, a 14 per cent increase since 2014. Our strategy recognised the need to build on our world-leading commitment to provide 12 months of post-diagnostic support following a dementia diagnosis and to expand the resilience of our dementia communities. More than £9.5 million has already been directly invested nationally to achieve this since 2021. We have worked collaboratively with people with lived experience and national and local partners to develop our first two-year delivery plan, which we will publish next month. Mark Ruskell I thank the minister for that response. Organisations such as Townbreak and Meeting centres provide essential support to those living with dementia and their carers in Dumblane and Stirling. From peer support to social activities, those local independent groups provide exactly the care that people need to add life to years. However, the future of those groups is at risk, and the local health and social care partnerships funding for dementia services is unclear for the next year. Does the minister agree that all efforts should be made to properly fund those community-led dementia support groups as part of the Government's strategy? Our strategy, which was developed in partnership with COSLA, makes clear the importance of community support and the role of localities and the people who live there in deciding what dementia services and support fits their needs. In addition to the £2.2 billion that I have already set out, which is provided to HSCPs to fund dementia care, the Scottish Government has invested £1.5 million via Age Scotland since 2021 to enhance and sustain community-led support. I have personally seen the impact on people with dementia and their families, and we are committed to continuing to work with local partners to improve access and to better co-ordinate available support. The minister will be aware of links from audio and visual sensory loss to dementia. Given that there is such a strong connection in highlighting how important audio and visual stimulation is to keeping parts of the brain active, why is there no routine eyesight or hearing test provided as standard in our elderly care facilities? I am happy to write to the member with further supplementary information, but I should be aware that everyone in Scotland has access to free eye testing, and very often that is in the provision that optometrists go out into community settings where people are not able to access that on the high street. I will ask my colleague Jenny Minto to update her on progress with community audiology. To ask the Scottish Government what research it has undertaken on the impact of changing demographics on NHS services. The Scottish Government has not undertaken specific research on the impact of changing demographics on NHS services. However, any Public Health Scotland is currently undertaking research that will inform discussions on NHS services impacted as a result of the projected changes to the burden of disease and demographic change. It is anticipated that the research will be published on Public Health Scotland's website by the end of 2024. Christine Grahame I thank Cabinet Secretary for his answer. There are over, as he is aware, 1 million Scottish residents, and that is increasing. Living longer can be a plus, but with age regrettably come more demands and specific demands on the NHS. Can I ask whether the waiting in INRAC, which then allocates to NHS boards and the formula needs reviewed in the light of the increasing number of older people? The way in which the INRAC formula operates is that it takes into consideration a range of factors, including demand for healthcare services in a health board area. The member may be aware that we have committed to undertake a review of the INRAC formula. However, it is a complex piece of work and it will take some time. On the broader point that the member raises, a key part of dealing with the increasing burden of disease that we will face over the course of the next 20 years, it is critically important that we look at the potential impact that this will have on NHS services, which is exactly what this piece of work that has been carried out with Public Health Scotland will assist us in understanding so that we can then evaluate its potential impact in the years ahead. Thank you. Unfortunately, we run out of time in terms of NHS recovery, health and social care. Put full of questions and apologies to those I was unable to call. There will be a brief pause before we move to the next item of business to allow front benches to change.