 The first item of business is general questions, and at question number one, I call Rhoda Grant. To ask the Scottish Government whether it will conduct an independent review into the maternity model in Caithness. Cabinet Secretary, Humza Yousaf. The maternity model in Caithness was put in place by NHS Highland that was following a review led by Professor Hugo Van Warden, then the NHS Highlands Director of Public Health, following the tragic death of a full-term baby at the unit in 2015. The report of the review, which included two external reviews, recommended that the maternity unit in Caithness moved to a midwife-led unit to address safety issues. That change was unanimously agreed by the NHS Highland board. The model of care that operates in Caithness is, of course, similar to models that operate in other parts of NHS Highland and other NHS boards in Scotland. The member will be aware of the work that is under way in the best start North review, commissioned jointly by Grampian Highland and three island health boards. The work of the review group was paused during Covid but is recently restarted, led by the directors of Midwifery from all six northern boards. Rhoda Grant. The Cabinet Secretary has carried out independent reviews of money maternity services and now has commenced one in Dumfries and Galloway. The review carried out by NHS Highland was not independent of NHS Highland. Concerns around the maternity services have been on-going since that change was made back in 2016 when obstetric cover was removed. Women are having to travel over 100 miles to give birth. That is like asking a woman from Edinburgh to travel to Newcastle to give birth, and that is absolutely unacceptable. Will he stop the centralisation of maternity services away from Caithness, admit it was a mistake and commit to having a full independent review as soon as possible? Cabinet Secretary. I really regret Ms Grant's tone in terms of her question or even her implication. It is important for us to remember, as I stated in my original answer, that the review was carried out after the tragic death of a full-term baby at the unit in 2015. That was the circumstances behind why there was a review, and that review did include two external reviews as part of the overall review. That review, the basis and the back of that tragic death, recommended that Caithness move to a midwife-led unit to address those safety issues. Ms Grant is also wrong to say that I have commissioned an independent review in relation to maternity services in Wigtonshire. The local health board has decided to commence an independent review into maternity services in Wigtonshire on 18 January. That is the decision for the health board. The health board in Highland is a part of the best start of north review, which will look at how maternity services operate across Highland. I hope that Rhoda Grant will undoubtedly collaborate and take part in that review. Can the cabinet secretary confirm if the Scottish Government has reviewed the conclusions of the risk assessments for each maternity patient who is in labour that has been transferred from Caithness general to Rhaigmoor hospital? If not, will he? Those are important decisions and important risk assessments for local health boards to take. Of course, I understand the concerns that are raised by Edward Mountain and Rhoda Grant. I, myself, have met the campaign group chat last year and as a result of that, I know that there is now face-to-face formal meetings between NHS Highland and the campaign group. NHS Highland has in place protocols in place to mitigate the risks that are associated with the transfer of pregnant women, particularly in an emergency situation. Those protocols are in place. The best start in north review has commenced. As I have encouraged Rhoda Grant, I would encourage Edward Mountain to engage in that review. To ask the Scottish Government whether it will provide an update on the development of a menopause specialist network. The action in the women's health plan to develop a national menopause specialist network has been completed. The network has been meeting since 2021 to provide consistent advice, peer support and share good practice amongst healthcare professionals, including primary care teams. The network meets on a quarterly basis and includes representatives from all mainland NHS boards. I thank the minister for that answer. It was recently estimated that in the UK over 900,000 employees left their jobs over an undefined period because of the impact of menopause symptoms. In addition to better clinical support for women during menopause, better understanding and support is needed in workplaces. I know that I am potentially creeping into another minister's remit here, but I would like to ask if, in the spirit of cross-portfolio working, if some work could be done within the women's health brief to better inform workplaces on the menopause and get meaningful policies in place, perhaps starting with our own NHS, which, after all, employs many women, women that we cannot afford to lose from the workplace? Our women's health plan highlights the need to consider women as rounded individuals with a range of needs. We are committed to working across portfolios to achieve our aim of reducing health inequalities and improving health outcomes for women, including in the workplace. Menopausal women are the fastest-growing demographic in the workforce, so it is important and more important now than ever to speak openly about the menopause at work. Through the women's health plan, we are developing support for employers and those experiencing symptoms of the menopause. That includes menopause and menstrual health work that place policy for NHS Scotland as an example of best practice to promote across the public, private and third sector. Last week, the Scottish Government published its women's health progress report, which was delayed by six months. Can the minister explain why the establishment of a dedicated menopause policy post has not been achieved? In the Government's own implementation plan, that was classed as a short-term action, so it should have been delivered within the year. When will an appointment be made? I am very proud of the progress that we have made in the first year of the women's health plan. Of course, Scotland was the first country in the UK to put forward a women's health plan. I have been very clear from the moment that I took the post that we have a great deal of work to do to overturn the millennia of discrimination and disadvantage that women face. We have done great work on menopause. We have put forward, as I said in my previous answer, the access to a specialist menopause workforce. We have busted myths about the menopause on our NHS inform website. I am really proud of the progress that we have made. I am happy to update Jackie Baillie in writing with the specific question that she asked. To ask the Scottish Government what steps it is taking to support young people's speech difficulties. Cabinet Secretary, how is the use of it? We want to intervene early to prevent speech difficulties arising in young people and important part of our efforts to address that has been to increase our health visiting workforce by more than 500 since 2014 and expand funded early learning and childcare to the 1140 hours to all eligible children. Both are critical to supporting children's early language development. We also recognise the importance of timely access to speech and language therapy. We have increased the flexibility that health boards have in reducing waiting times, ensuring those with the greatest need are seen first while maximising prevention and early intervention approaches for those who are waiting. The cabinet secretary talks about early intervention, but the reality is that there is a two-year waiting list in North Ayrshire to see a children's speech therapist. In fact, the list is now closed and parents are having to go private to pay for assistance for their children. There is a two-tier system of speech therapy in Scotland due to chronic underfunding and a nationwide lack of speech therapy. I am sure that members across the chamber will be experiencing similar issues. How have we get let things get so bad? Early intervention is absolutely key to the learning and development of young people, but if there is a two-year waiting list then the outcomes are going to be much, much poorer. Will the cabinet secretary reflect on that and what is he going to do about it? I will not reflect on it, but we will make sure that we take action in that regard. He is right to raise the issue around Ayrshire and Arran. I know about the specific challenges that Ayrshire and Arran have had with recruitment. In fact, they have lost some staff in their speech and language therapy department. What I have asked the chief allied health professionals to do is to engage directly with the board. She has asked Ayrshire and Arran to resume the waiting list for routine referrals, because I know that that was an issue of concern. I understand the decision that Ayrshire and Arran took to close the list for routine referrals. It is important to say that that never affected urgent referrals. Urgent referrals are still being seen. In fact, the average referral to assessment time is four days. Where I do not agree with Jamie Greene's suggestion that the NHS is being chronically underfunded, that is incorrect. Of course, we are putting record investment in our NHS with a record £19 billion for £23.24. Question 4, Liam McArthur. Thank you to ask the Scottish Government whether it will provide an update on the work of the ferries task force with Orkney Islands Council. Presiding Officer, the Transport Minister and I had a useful meeting with representatives of Orkney Islands Council earlier this week. We discussed a range of matters about how best to support the council with the challenges it faces in delivering its ferry responsibilities, and we look forward to continuing discussions. Liam McArthur. I thank the Deputy First Minister for that answer. Welcome to the meeting on Tuesday. Given how late in the day the meeting was arranged, I welcome the fact that I think a further meeting is due to take place in April. It is important, vital, I would say, that ministers remain involved in this process. Given the impact on island communities in Orkney, of increased disruption to services due to the age of the internal ferry fleet, not to mention the costs and the impact through higher emissions, what confidence, what reassurance can the Deputy First Minister offer my constituents that this is a process that will lead ultimately to a funding package that will allow the replacement of that fleet? I think that the fact that the work is under way should be reassurance to Mr McArthur's constituents. I recognise the significance of the issues involved and the necessity of their being reliable inter-island ferries and connections for his constituents. We have embarked on the work that is necessary to explore those issues, and we look forward to sustaining that work with Orkney Islands Council. Jamie Halcro Johnston. This meeting has finally taken place and that the talks were, at least in the Scottish Government's own finance ministerial technology speak, positive and constructive. However, I am not aware of any agenda being published ahead of the meeting. Can I ask the cabinet secretary to ensure full transparency of the discussions and so that local residents in Orkney can have confidence that this is not just another talking shop and, whereas one local council has put it, a placating tactic, when will full detailed minutes of the meeting be publicly available and when will the agenda for the next talks be published? It's nice to see that Mr Halcro Johnston is able to summon up a really warm welcome for the Government's dialogue with Orkney Islands Council. It really is another further descent into the miserabilism of the Scottish Conservative and Unionist party. There is an abundance of miserabilism on the Scottish Conservative benches. If you could answer the question briefly, please. As with all things, there will be full transparency from the Scottish Government. I do. Members, we will hear the cabinet secretary. We have a finite amount of time and a lot of interest and I would be grateful if we could get through business. And there's a finite time that we've got to put up with the nonsense we get from the Scottish Conservatives. I simply reiterate, Presiding Officer, that the Government will apply full transparency to all of the deliberations that we have with Orkney Islands Council. Thank you to ask the Scottish Government what its position is on whether any increased number and cost of commissions and commissioners for which it is responsible will mean resources being diverted away from front-line services. Cabinet Secretary John Swinney, the financial resources sought by such office holders to support their respective functions are provided for in relevant acts of Parliament, which is a matter for the Parliament. It is a simple matter of fact, however, that the more office holders there are and the more resources they utilise, the less will be available for public services. I have been open with Parliament about the scale of the pressures that we currently face in the public finances and it is vital that all public bodies and office holders contain their costs. Thank you Deputy First Minister for that response. It's been suggested that we might be heading towards 14 commissioners and I wonder if he would agree that perhaps it means that some sectors with a commissioner have a louder voice and other sectors without a commissioner are not heard so well. Cabinet Secretary John Swinney, this is a difficult issue for the Government to judge upon because essentially the legislation to establish commissioners are matters for Parliament and Parliament also through the work of the Scottish Parliamentary Corporate Body has to regulate or revise on the regulation of the financial assistance that is made available to office holders and that's a difficult issue for the Government to control because it would potentially have the Government intruding on the right and proper space that is available for Parliament to determine these issues and I'm acutely conscious of the necessity to respect that boundary. Having said that, all of us, whether we are members of the Government or members of the Opposition, have a duty to recognise the pressures that exist on the public finances and that should be reflected in the financial support that is available to office holders and the number of office holders that we have in place. To ask the Scottish Government what impact its town centre action plan is having in communities in Mid Scotland and Fife region. Minister Tom Arthur. In Mid Scotland and Fife the Scottish Government is delivering on town centre action with more than £22 million of funding provided to local authorities for local projects since 2019 for our place-based investment programme and town centre fund. A further £4.5 million is being invested through the regeneration capital grant fund over the period 2020-23 alone. We are also supporting community wealth building pilots in Fife and we are working collaboratively with the co-field regeneration trust in the area on climate action. I appreciate the response from the minister but I think he is missing the point. I have asked this question in three different ways too in writing and again today and I keep getting told that we have a plan and another plan but the plans are not working. We will briefly suspend business at this point. Thank you. If we may recommence and if Minister Tom Arthur could complete his response to Ms McCall, thank you. Presiding Officer I have completed my response that was a supplementary. Sorry, excuse me. Thank you. I do appreciate the response from the minister but I think he misses the point. I have asked this question in three different ways too in writing and again twice today. I keep getting told that we have a plan and another plan but the plans are not working. Shop vacancies rates remain unchanged with one in six stores in our high streets lying empty, that is the highest in the UK. The volume of empty units in shopping centres remain at more than 20 per cent, that is completely unchanged. Calls from the industry bodies to match the 75 per cent rates relief for small businesses to match the rest of the United Kingdom are being ignored. What tangible evidence does the minister have that those multiple plans will make any impact whatsoever on the communities in Mid Scotland and Fife? I am grateful to the member for the supplementary question. That is a complex area. Our town centres face systemic challenges going back many, many years. Of course, they have faced the acute crisis of the pandemic and indeed the current cost crisis. There are three aspects to how we address that, for the clear strategic direction that we are providing. There is partnership working with COSLA and local communities and, of course, there is funding that is outlined in my original answer. There is no short-term fixed, no overnight solution to the challenges that our town centres face. It is not unique to Scotland that we have a strategic approach through our town centre action plan, through our retail strategy and through our community wealth-building aspirations. Indeed, I launched a consultation on community wealth-building earlier this week. We see in Mid Scotland and Fife, in Clackmannanshire and in Fife, pilot areas that are supported by the Scottish Government. That is a complex area. We are providing funding, we are working in partnership and I extend an invitation to the member and indeed any member who wishes to discuss complex issues in more detail. I am more than happy to meet to do so.