 I call Parliament to order, and we move on to our next item of business, which is topical questions. We start with question number one from Alex Cole-Hamilton. To ask the Scottish Government what action it will take in response to the reported increase in the number of GP practices being run directly by NHS boards. Cabinet Secretary, Shona Robison. Felly run practices are a legitimate way in which NHS boards can tailor services to meet local needs, ensuring that primary care services are provided to all patients. Wherever a practice hands back its contract, the local NHS board will ensure that primary care services will continue to be provided in the area and patients will be able to see a GP. If a practice can't routinely accept new patients, we're clear that boards must work with practices to help manage a situation and ensure that all patients are informed of options being considered. In support of general practice, I announced on 10 March an investment of £71.6 million. This new funding forms the first stage of the Scottish Government's commitment to provide an extra £250 million in direct support of general practice per year by 2021 and will increase the investment in primary care by £500 million. By the end of this Parliament, for the first time, at least half of front-line NHS spending will be going to community health services. Alex Cole-Hamilton, I thank the cabinet secretary for that answer. Further to the contributions that we have just heard, I would like to put on my record my thanks for everything that our health and emergency services do for us. They do heroic work in our communities every day and, as we have seen so tragically overnight during the darkest of moments too, there won't be a soul in this building whose heart doesn't go out to those working today in the most testing of circumstances. They deserve the full support of this chamber and this Government, but they don't always get it. Last year, doctors at East Craig's Park Grove Medical Centre in my constituency attached letters to prescriptions asking their patients to contact me for help, such was the strain on that practice. Is the cabinet secretary confident that her Government is doing enough to identify and to help surgeries in the early stages of distress before they have to be taken under health board control? First of all, I say to Alex Cole-Hamilton that our NHS has offered support to services in the NHS, particularly in the area of plastics and pediatrics, where the specialties can be in short supply to reassure the chamber that that offer has been made, as well as beds within Scottish hospitals if required. We are very much in touch with the services down there. In reply to Alex Cole-Hamilton on the specifics of the medical practice and, indeed, support in the early stages, I have very much encouraged boards to have early discussions and encourage practices to have early discussions with the health board and to alert the local health board if they are entering difficulties at an early enough stage to try to provide support and to try to avoid some of the difficulties that we have seen. In reply to what we are doing, Alex Cole-Hamilton will hopefully be aware of the intensive work that is going on around the new GP contract negotiations. That is going to be very important in providing a better future for primary care and for general practice within it and a more attractive proposition in order to attract young doctors into general practice rather than other specialties. We also have the GP recruitment and retention fund, which we announced is increasing fivefold from £1 million to £5 million in 2017-18. That investment will enable us to expand and continue to explore the issues around GP recruitment and retention across Scotland, which we know can be particularly challenging in certain areas. Within that, there are a lot of initiatives, whether that is the GP Fellows, whether it is the development of a local pool of retired GPs in Lothian, the RC GP recruitment programme, the GP returner scheme, run by NES, the new national GP recruitment website. There are a lot of local initiatives in addition to those that boards have taken forward. I hope that I can reassure Alex Cole-Hamilton that, despite some of the difficulties, a lot is being done and will be done so that we can encourage young doctors into general practice and, meanwhile, support those practices that have challenges. Alex Cole-Hamilton I thank the cabinet secretary for that answer and I am very grateful for the information that she shared with the chamber, particularly in respect of the help that is being offered by Scottish health boards to Manchester. One of the commitments of the Government's recent mental health strategy was to hire some 800 link workers at GP practices, A&E, police stations and prisons. As the health secretary knows, my party has stated our view that instead of link workers, we should seek to recruit talking therapists for GP surgeries to offer early intervention and de-escalate crisis situations. Given that one in four patients present to doctors' appointments with an underlying mental health condition, does the cabinet secretary agree that having a talking therapist on hand in a surgery would be far more useful in reducing GP workload than a link worker who may only be able to refer a patient to the back of a waiting list for psychiatric treatment? Alex Cole-Hamilton Well, let me say a couple of things about that to Alex Cole-Hamilton. First of all, the 800 staff that he described that the First Minister announced that we will be particularly focused around A&E departments, GP surgeries and indeed in the police environment in terms of not just the cells but potentially also when the police go out to a call that may involve someone with a mental health issue. Those 800 staff will be of a variety of skills and backgrounds and will be appropriate to what is needed for that setting. Alex Cole-Hamilton says that the link workers, as part of that, provide a very important role because they can often make sure that the person gets access to the right resource, whether that is a mental health voluntary organisation or a mental health service within the NHS. The link worker is doing an important job, but we will make sure that the workforce that has been described is appropriate for the skills that are required in each of those settings. Ben Macpherson Can the cabinet secretary please outline any benefits of GP practices being run directly by NHS boards? GP practices run directly by boards help to ensure continuity of care for patients and connect those practices into a wider network of services. That helps to ensure that patients continue to receive safe, effective and timely care. It can sometimes be a board's contractual choice. For example, in Orkney, half of all practices in Orkney use 2C contracts are practices run directly by boards because that has worked well for Orkney in terms of being able to provide the types of services needed by the local population. There can be benefits for practices run directly by boards, and I hope that I have been able to give Ben Macpherson some examples of that. I associate myself with the comments of Alex Cole-Hamilton about last night's events. I likewise welcome the information just given by the cabinet secretary about assistance. Given that 1 in 20 GP surgeries are now under the control of a health board, that will inevitably lead to additional costs that require to be borne by health boards across Scotland. Has the Scottish Government quantified that expenditure, and is the cabinet secretary satisfied that health boards are able to meet those costs? Yes, we are satisfied that the health boards are able to meet those costs because, obviously, we have been expanding the resources going into primary care. I described the investment in my initial answer for 2017-18 of an additional £71.6 million, but that provides the first stage of a commitment to providing an extra £250 million in direct support of general practice per year by 2021 as part of a wider £500 million investment. Of course, the health board would be contracting with the GPs to provide those services if they were under the independent contractor status, so they would be funding that through a different route than they would be if they were providing those services directly through the health board. I hope that I can give Donald Cameron assurance that we are working with boards to make sure that, whether it is through independent contracting or whether it is through direct provision of services through health boards, that we are committed to ensuring that every community has access to good quality primary care services. My son is eight years old. I have seen the joy in his face at a concert, and I can only begin to imagine the tragedy that is going through every single family in Manchester. I also want to put on record our thanks to all our amazing NHS first responders. People naturally run away from danger. Those first responders run towards danger to help and care for their fellow citizens. One of the issues that are raised regularly by GPs is around the obligations that they feel about running a business practice rather than purely caring for patients and one of those conditions is around looking after a property. One of the requests that often comes is that, through the GP contract process, if the health boards can take responsibility for the properties and let the GPs get on with running the practice, is that something that has been actively considered as part of the GP contract process? Can I thank Hanna Sabar first of all for his earlier remarks? For his question, he may be aware that the GP premises short-life working group reported in December of last year, and the group recommended that the Scottish Government recognise and support a long-term shift that gradually moves general practice towards a model that does not presume GPs own their practice premises. We are implementing the recommendations of that short-life working group and is moving to that service model. We are going to issue a code of practice to guide health boards when deciding whether to purchase a GP-owned property or take on some or all of the contractor's responsibilities under an existing lease. We are going to be issuing revised premises directions and carry out a nationwide survey of all GP premises to better understand the challenges facing the state. Is something that we very much recognise and are working closely with the BMA and others to move forward on that issue? To ask the Scottish Government what action it is taking to improve cycling infrastructure in light of recent research by Sustrans Scotland, which highlighted that T-junctions and roundabouts possess the highest number of collisions. Transport Scotland welcomes the report, which helps to inform our partnership work with local authorities and Sustrans to make our roads and cycle network safer by tackling dangers roundabouts. Junction local authorities are funded through cycling walking safer streets and are encouraged to apply to Sustrans Scotland for further Scottish Government funding through the community links and street design projects for exactly those type of junctions and roundabouts. Our road safety Scotland framework to 2020 mid-term review identifies cyclists as a key priority area. Through our programme for government, we are committed to maintaining the record levels of funding in active travel, which includes capital funding for improving infrastructure. Alexander Stewart I thank the minister for that answer. The minister will be aware that in my region of Mid Scotland and Fife, Dunfermlyn and Perth have been named among the top 20 cycling collision hotspots in Scotland. Can I ask the minister why the Scottish Government was overseeing cuts to cycling infrastructure? I just have to clarify that misinformation from the member was sure unintentionally that, as I said in my previous answer, we have record levels of funding in active travel, which is £39.2 million per year to 2021. There is a record level of investment. I know that other members across the chamber will no doubt want us sometimes to go further than that. Where there is additional expenditure that I can find that can be spent on active travel, I will certainly do that. In terms of the region that the minister represents, it would be worth highlighting some of the successful projects that have been funded, many of them through Sustrans, which we again helped to fund. In Fife and Cowdenbeath, we have the place-making scheme, which is the redesign of the town centre junctions. We will improve access. We are looking at other Rothys Road improvements to the Tukun crossing, which included money from Sustrans. That has community links funding of £870,000. Carnegie Avenue has a shared use path of 1.2 kilometres of new 2.5m to 3m shared use paths for the extension of the Clyde Dunfer on the Network. There is a lot of funding going into Mid Scotland and Fife. I would encourage local authorities, many of them with new administrations, many of them with existing administrations, to work with Sustrans, where there needs to be an improvement on the basis of the Sustrans report and bid for the community links projects and funding that is available. Alexander Stewart. I thank the minister for that answer. I also thank him for identifying areas across my region that are being tackled, but there are still areas of minister that require to be tackled. Some additional support such as traffic lights and other quality infrastructure around roundabouts and T-junctions have proven to reduce accidents and fatalities. Many cyclists have endured serious injury or even death because of the areas that they have had to endure. Can I ask the Government once again to clarify exactly what they are attempting to bring forward? As you say, minister, in some parts it seems to be working, but in other parts it is not. I thank the member for that follow-up question. The report was commissioned because we had good analysis and good data on where some of the cycling hotspots and injury hotspots were on our trunk road network. What we did not have data for and what Sustrans thought was eminently sensible was to gather some of that data for local roads. That was the whole purpose of having conducted that exercise. Now that we have the evidence, we are in discussions with Sustrans about what other schemes are, as well as a community link scheme, which I have talked about. We are discussing with him whether there are merits, for example, to have a community link junction improvement scheme. That scheme might be something that would be of interest to local authorities. My strongest advice to the member would be that he continues to engage with the local authority and that I know that he knows well. Look at the evidence base that Sustrans have provided and continue to apply to the current programme of funding that exists exactly for that type of infrastructure. If there are other funds that are available, I will make sure that the member is made fully aware of them. However, there is a part of funding there that is available to try exactly to help. I think that with the evidence base that the report helpfully gives us, that would make their case very strong indeed. Thank you very much. Apologies to members. There is not enough time for additional supplementaries. The next item of business is a debate on motion 5655 in the name of Julian Martin. We will just take a few moments for members to change seats.