 I have business today is portfolio questions and we start with question number one from Richard Lyle. To ask the Scottish Government what the NHS policy is on prescribing wigs for patients receiving private healthcare. The prescribing of wigs is dependent on clinical assessment and individual need. The Scottish Government has previously issued guidance on the provision of wigs to all NHS boards to allow them to deliver services that meet the needs of their local population and we would expect any independent healthcare provider to administer all necessary treatment for each episode of care. Richard Lyle. I thank the cabinet secretary for that answer. Being told that you have cancer is a blow to anyone, especially family members, what a cancer sufferer does not need, whether they are private or NHS patient, is officialdom or red tape. That is what the lady got until officials realised who they were dealing with. The policy is quite clear and should be implemented that way. My thanks to the officer in space for answering my inquiry in the matter of hours. As I spoke to the patient, her young son drew this. It says it all, we want the wig. Her son said it all. The patient got her wig by the way. My question is will the cabinet secretary ensure that a policy set out to aid all cancer patients is implemented correctly and that patients, whether private or NHS, are treated with respect and get the service that they deserve? Cabinet secretary. I am grateful to Mr Lyle for his supplementary and I couldn't agree with him more when you receive a diagnosis like cancer or indeed any other life-threatening diagnosis such as that. The last thing that you need is more red tape and bureaucracy. I am very happy to confirm that I will ensure that our guidelines are reissued again across all our boards but also to those private healthcare providers that we are in contact with to ensure that all our patients are treated with the dignity and respect that they deserve. Monica Lennon. Thank you. I have also been assisting a constituent. She has alopecia and that has prompted me to write to health boards to ask for a breakdown about the number of real hair wigs that are offered to patients alongside synthetic. It is proving very difficult to get the data, cabinet secretary. Is there anything that the Scottish Government could do to help health boards to improve the data that they hold so that patients with alopecia and other conditions get the right type of wig that they need and deserve in terms of quality? Cabinet secretary. I am grateful to Ms Lennon. This is a really important issue. My understanding is that NHS patients may receive up to four water-described stock wigs as required per year for human hair wigs. New patients with long-term hair loss may be prescribed one human hair wig per year or two initially in the first year to last 24 months and then one wig per year thereafter. My understanding of what is currently, I am quite happy to write to the member and set that out, but also to look a bit further at the way in which data is collected by our boards so that the kind of questions that Ms Lennon is asking can be more easily answered. In the meantime, I will set that out for you. Thank you very much. Question 2 has been withdrawn. Question 3, Gil Paterson. Many thanks, Presiding Officer, to ask the Scottish Government how the roll-out of GP premises sustainability fund will help to reduce barriers to recruitment of GPs. Cabinet secretary. The GP premises sustainability fund, a long-term interest-free loan of up to 20 per cent of premises value, is in direct response to concerns raised by the BMA and GPs and it aims to ease the financial risk associated with owning a premises and, in turn, there for helping GP recruitment and retention. The risk is considered to deter particularly new GPs as they need to raise funds to buy into practice premises and are anxious or unwilling to take on the associated financial risks. That has been evidenced as a barrier to some degree to recruitment. The roll-out of the GP premises sustainability fund, the first 30 million, has already been approved and allocated. We last week announced an additional 20 million to that fund and the reopening of applications, bringing forward the timeframe between 2019 to 2021. So far, all the feedback that we have had from those GPs and indeed from the BMA has been very positive in responding directly to their concerns and we hope that easing this risk and increasing recruitment and retention. Gil Paterson. I thank the cabinet secretary for that answer and to say that the feedback that you have got is very similar to my own because I know that this is a very critical factor in GP practices in my own constituency. Therefore, I very much welcome the Scottish Government's on-going commitments to the recruitment and retention of GPs. You have answered some of the questions, cabinet secretary, and I thank you for that. Can the Scottish Government confirm how much funding has been allocated in total to support both the GP premises loan scheme and the GP contract? We had initially allocated over 140 million to support both the premises loan scheme and the new GP contract and wider primary care reform in 2018-19. That 30 million, of course, was part of that 140 million. I have now increased to 50 million. That in total is our current investment in this aspect of the recruitment and retention of GPs. Miles Briggs. I welcome the GP premises sustainability fund and indeed called for it some two years ago. It is vital that we make sure that Scotland's GP surgeries are sustainable and that any prohibitive costs are addressed, which face GPs and GP staff. The vast majority of GP practices across the country, including 793 surgeries, are privately run by doctors themselves and not the local health board. Can I therefore ask the cabinet secretary if she can confirm today that all GP surgeries in Scotland will not be included in the SNP carpark tax proposals? I have to say, Mr Briggs, that is such a wasted opportunity on your part. You are the shadow spokesperson for health, and that is the best thing that you can do. You know as well as I do—and we will debate this tomorrow—that what is being talked about here is an additional power for local authorities to use or not as they choose. What the finance secretary has made clear more than once—I believe that I have done it too—is that NHS staff will not be required to pay that tax should the local authority concerned implement it. Of course, that applies to those GP premises that have a contract with us to provide NHS care. How much clearer can we be on this? Perhaps the next time, you would ask a question that is relevant to the health portfolio. I welcome all and any initiative to improve the sustainability of general practice, particularly in rural areas. However, I read in the national code of practice that health boards will have a new power to withdraw both notional rent and borrowing cost payments to GPs. Could the cabinet secretary outline in more detail where and when the new powers could be used? Mr Stewart, I am grateful to you for the question. You are referring to the new scheme in terms of lease. Some GP practices, as we know, own the premises. That is where the loan scheme comes into play. Others, of course, do not own but rent their premises. What we are offering is an opportunity for those GP practices for that lease to be taken on by the health board, thereby alleviating some of the risk that the practice might face in terms of a private landlord, and offering longer-term security to the lease provision. That is what Mr Stewart is asking me. That is part of the overall primary care reform programme and is already under way. It will be taken up much more so, I am sure, in 1920. Again, if the member wants more details on that, I am very happy to provide it. Neil Findlay. For the first time since the creation of the national health service in 1948, the village of Stonyburn has no GP service. The premises are there, they need improvement, but there is no doctor within the health centre. Does the cabinet secretary agree with me that that is completely unacceptable? Will she come with me to see the premises and to speak to local people about the fact that they no longer have a GP? My understanding of the situation is that my officials are in contact with Westlothian Health and Social Care Partnership, who have planning and commissioning responsibility in this area. They have advised me of the decision to continue to provide consolidated GP services for all patients registered at the brief rally medical practice, including patients living in Stonyburn, that they remain committed to retaining the Stonyburn community health centre, where patients can access a wider range of community health services, including district nursing, health visitors and so on, and are also looking at ways of bolstering services to the Stonyburn community and with housebound patients continuing to receive exactly the same services as they do at the moment. What I am happy to do is to look further at this matter, indeed discuss it personally with Mr Finlay and see if there is more that we can do at this point. Question 4, Claudia Beamish. To ask the Scottish Government what role the third sector organisations such as Healthy Valleys in Lanark play in supporting preventative health and other community-led health initiatives. Minister Joe FitzPatrick. I will take the opportunity to acknowledge the very important work that community-based organisations such as Healthy Valleys play in addressing the challenges of inequality in health and the complex issues that lie behind those. Scotland's strong and dynamic third sector plays a crucial role in the drive for social justice and inclusive economic growth, and it is essential to the reform of public services and to the wellbeing of our communities. That is reflected in our continuing financial support for the core third sector budget and a range of other planned expenditure across portfolios. Claudia Beamish. I thank the minister for that answer. Of course, the core budget is very important. Does the minister agree with me that there needs to be some sort of guidelines—I do not know if the Scottish Government has this already—and specific plans to help organisations such as Healthy Valleys to gain a more assured future as organisations, as many are reliant on short-term unreliable grant funding, which makes it difficult to support specialist and, indeed, quite remote rural areas in working preventatively with continuity? I thank the member for the point. We would absolutely encourage organisations such as Healthy Valleys to work with their funding partners to support them to continue their good work on a more sustainable basis. The Scottish Government continues to look at how we can support this activity and we are considering how future funding under Empowering Communities Fund can be streamlined to support that and improve delivery. Brian Whittle. I recently attended the launch of a collaboration between two thirds sector organisations in Yipworld and Cycle Station. I think that that sort of collaboration is something that we would like to see promoted. I wonder if the minister agrees with me that the way that the third sector is funding makes this type of collaboration difficult and isn't it about time we looked at the way we can align the third sector and fund them in such a way that this type of collaboration becomes more and more? I think that the member makes a good point. I think that I have already said that collaboration is really important and those sorts of organisations need to work with their funding partners. There needs to be partnership working. The models of social prescribing are something that we all agree that we want to encourage in the future. Part of that is to look at how we use the funds that we have. That is why it is important that we are specifically looking at what the funding models are and how we are using those funds under the empowering community funds to better streamline delivery. We need to make sure that right across all portfolios that were joined up as possible to make sure that we are supporting the kind of initiative that the member mentions. Question 5, Liam Kerr. To ask the Scottish Government what plans it has to review the NRAC funding formula for NHS boards. Cabinet Secretary. There are currently no plans to review the NRAC funding formula for NHS boards. The formula has been used in NHS Scotland since 2009 following its approval by all NHS boards and the technical advisory group on resource allocation. It is updated on an annual basis on the basis of statistical analysis by experts and remains the most objective and robust method of allocating health service funding on an equitable basis. Liam Kerr. This year, our health boards are getting an average uplift of 3.8 per cent. That is less than the 5.3 per cent uplift for the overall health budget. Health boards deliver the vast majority of NHS work and, thanks to Barnett consequentials and the spending decisions of the UK Government, an extra £2 billion is coming north for our NHS. How will the cabinet secretary allocate this extra money to guarantee our health boards get the funding that they deserve? Cabinet Secretary. Of course, Mr Kerr is displaying a significant misunderstanding of all the funding in our health service and the various means by which it gets to patients, which is actually the most important thing. Of course, NHS boards receive an allocation in addition to the waiting times improvement plan, which is providing additional resources, the £160 million in the draft budget. Of course, it depends on this Parliament approving that draft budget tomorrow, which includes in that the funding to extend free personal care to under 65s. Something that I know Mr Briggs was very keen to promote, quite rightly, and I hope that he will support tomorrow. All of that is going, but £160 million for those additional provisions goes through our health and social care partnerships going to local authorities. If you look in the round overall the level of health spending on patients and, of course, our commitment that we honour consistently to pass all health consequentials into the health portfolio, you will see that we continue to increase our spending in health and are on track to achieve our target of shifting the balance of care from acute to that community setting. Does the cabinet secretary agree that there would be any increase in NHS funding if the budget is not passed tomorrow? Does she also agree that any future review of the NHS Scotland Resource Allocation Committee funding formula must take greater account of poverty and deprivation, given that those are primary indicators of likely health need? Of course, Mr Gibson is completely accurate. It does depend on the Parliament's decision tomorrow on the draft 19-20 budget exactly where we stand in terms of our health service. I remain ever hopeful that all members will understand the vital importance of the additional resource that we are putting into health and will find themselves able to support that. He is also right that poverty and deprivation are key elements in the NRAC formula in order to support access to healthcare according to need. Recent reviews, as I have said, by independent experts have ensured that the formula remains fit for purpose. Of course, as with all formulas, it is not an exact or perfect science and should always remain open to continued consideration as to its effectiveness. Mike Rumbles. The Scottish Parliament Information Centre has produced research that says that Grampian NHS has received £239 million below its NRAC target allocation over the past 10 years. Will the cabinet secretary accept that it is not the NRAC formula at fault here but the constant failure to meet the NRAC allocation every year since 2009? Mr Rumbles will know that what the Government has been trying to do in a staged manner, is of course moving all boards to as close as possible parity with the NRAC formula, which requires some boards to lose some funding as well as other boards to increase it. Over that time, we have moved progressively to get to a position where all boards are within 0.8 per cent of parity with the formula. Figures that he refers to are figures that date back to a point where Grampian NHS was minus 4.8 per cent in terms of its parity, close to parity for the NRAC formula. We are making progressive moves towards increasing the equity and fairness in the application of that formula. We will continue to do so on the basis that we need to do it in those stages because, of course, every penny of money relates to a direct service to patients and we need to take it in that staged and sensible manner. To ask the Scottish Government how it has enhanced the role of clinical nurse specialists in the NHS and what the benefits are. The role of clinical nurse specialists is an important one in our health service and they have developed across a range of specialisms over a number of years. What we are currently engaged in is a transforming nursing roles programme. Within that, the specialist short life working group has been established to look at the clinical nurse specialist role. The aim of it is to clarify the role, regardless of the specialism, reduce variation across our country and duplication in the roles and have a clear focus on what is the total education and training and support requirements to clinical nurse specialists to improve and enhance patient care. That work has begun. I am told that it is expected to be completed in a year's time, but I have asked officials if there is any way in which it could either produce some interim recommendations or complete its work much earlier than that. I thank the cabinet secretary and very much welcome that answer. RCN recommends that all children with epilepsy are seen by a specialist nurse. That is happening in every health board area in Scotland except in Freeson Galloway. Even the borders with a smaller population has this covered. Now, 150 to 250 estimated children and young people in Freeson Galloway live with epilepsy and while I understand that it is a matter for the health board, that is little comfort to those families. I wondered if the Government can put any pressure on Freeson Galloway health board to change its position and catch up with the excellent position in the rest of Scotland. I am grateful to Ms McAlpine for her supplementary question. I would share the concern that she has that Freeson Galloway appears to be an outlier in what is a pretty important area, not least for those families that she mentions. I am giving the member this assurance to now that I will personally look at why Freeson Galloway's board has taken the view that it has, what it proceeds to be the barriers in its way, as opposed to any of our other health boards, and how we might assist them to overcome those barriers and meet that recommendation. Michelle Ballantyn Given recent reports of extremely high accident and emergency demand at a boarders general hospital, which culminated in a public appeal by the director of nursing and acute services, urging people to only visit A&E in the case of serious medical emergency, I would like to ask how does the cabinet secretary see the enhanced role of clinical nurse specialist easing the pressure on NHS Scotland-strained A&E departments? There are a number of enhanced roles that can address the additional pressure on our A&E departments. Ms Ballantyn is correct to point to additional demand. We have been experiencing additional demand even over last year, which, as members will recall, was a particularly difficult year in terms of weather and flu and so on, but even over last year there is additional demand over a number of weeks across almost all of our A&E departments to varying percentage increases. As well as looking to ensure that all our emergency departments are applying the six key actions, which are agreed to be the six key actions, to ensure that they operate as effectively as possible. We are looking with health boards and with health and social care partnerships to other areas. One is the flow through the hospital. That includes delayed discharge, of course, but it also includes the flow through the hospital. I do not want to say to people, do not go to your A&E department. What I want the emergency department and the hospital front door to be able to do is to then signpost people appropriately. For example, the Royal Infirmary of Edinburgh has recently opened beside its emergency department a minor injuries unit so that people who are coming to that front door are properly signposted next door to the minor injuries unit where they will be treated properly. In that unit we have the role for a range of professional input, not least physiotherapists but advanced nurse practitioners as well as medics and clinical nurse specialists where that is relevant depending on the nature of the demand. We are looking at making the best possible use of the range of professional disciplines and skills that we have in our health service, increasing those and enhancing them but at the same time being able to give the patient the care and the skill that they need at the point when they need it. Emma Harper It is Government how the implementation of advanced nurse practitioners, which are different to clinical nurse specialists in primary care such as in GP practices, are benefiting communities, particularly in rural areas such as Dumfries and Galloway in my south Scotland region. Of course, Ms Harper is right in that advanced nurse practitioners do differ from clinical nurse practitioners. They have a really important role, which is why we have committed to train 500 advanced nurse practitioners by 2021. Their role in primary care and in GP practices and in some of the linked community-based services that I touched on with Ms Ballantyne earlier and others is to support joined-up, anticipatory and preventative care because they can work with individuals in their local community. In my constituency I have seen advanced nurse practitioners take on a number of roles inside that primary care setting, which has allowed the GP to step forward into the role that the new contract wishes the GP to be in and the BMA wishes them to be in, which is that clinical general specialist lead in that local community for that team of healthcare practitioners, including the advanced nurse practitioner. To ask the Scottish Government what it is doing to ensure that the commitment to develop rural clinics aligns with the needs of NHS boards and clinicians. We are committed to ensuring that healthcare services provide high quality sustainable care for patients across communities, including those in rural areas. Integration authorities are responsible for planning local services in line with national policies and local priorities, and they have a statutory duty to consult partners, stakeholders and professional groups as part of their strategic commissioning process. The memorandum of understanding, published alongside the new GP contract, is clear that primary care redesign needs to be safe, effective and accessible to all and agreed with local clinical professionals. That should help to ensure that in particularly remote and rural areas, but elsewhere across the country, the services that are redesigned under primary care as part of our overall primary care reform with that additional resource meet the particular needs of those local communities through that consultation and with that statutory responsibility on health and social care partnerships. Stewart Stevenson. The cabinet secretary will be aware that in many rural communities access to carers is important and access to transport is relatively limited. In the light of that, will the cabinet secretary encourage the integration services to take those factors into account when designing the new way in which rural clinics will be operated and offered? I am very happy to give Mr Stevenson that commitment. I know from my own experience that you can look at a map and think that it is not that far from A to B, but in that rural area it will take a great deal longer than it will do in perhaps our more central belt location. I am very happy to give him the commitment to make sure that our integration authorities take those factors into account wherever they are commissioning and planning services. Rhoda Grant. To ask the Scottish Government how many hours on-call ambulance drivers can safely work in addition to their day shifts. Cabinet secretary. All working patterns in NHS Scotland meet the limits of the working time regulations, which includes the average 48-hour working week and the required minimum daily and weekly rest periods. Over the last 12 months, on-call working for ambulance crews has been eliminated in Wick, Thurzel and Duftown. An announcement was made last week to recruit to six new ambulance posts that will eliminate on-call working in Portree. The Scottish Ambulance Service recognises the concerns that staff have around fatigue related to on-call working and have agreed in partnership a fatigue policy that is designed to address those concerns. Rhoda Grant. Ambulance crews in remote rural areas work their day shift hours and cover the rest of the 24-hour period on an on-call basis. That means that they work their full day shift but then be called out in the middle of the night. In my region, some of those call-outs can involve around a trip of over six hours on top of the day shift already worked. If they were employed as professional drivers, that would be illegal and indeed they could be charged with dangerous driving. They can register as fatigued that is up to them but if they do so, they cannot return home. Can I ask the Cabinet Secretary to investigate this practice and ensure that the health and safety of those crews and indeed their patients is safeguarded? Cabinet Secretary. I am grateful to Ms Grant for that supplementary question and I understand the point that she is making. I am happy to confirm to her that I will have further discussions with the Scottish Ambulance Service around that point and will write to her in due course on the basis of the outcome of those discussions. To ask the Scottish Government whether it will provide an update on plans to replace St Brendan's hospital in Barra. Cabinet Secretary. I am grateful to Mr Allan for his question and can I say at the outset that I completely understand the frustrations that I am sure he feels and certainly that local community feels what appears to have been a lengthy process. The health board, the local authority and the Scottish Government remain committed to delivering the St Brendan's reprovision at the earliest opportunity. The outline business case was approved in April 2018. Work continues between the health board, the council and the integrated joint board with the support of the Scottish Futures Trust to determine the best approach for delivery of the hospital project and the Castle Bay community hub, integrated or separate solutions to ensure that public infrastructure best meets the need of the local population and provides effective and sustainable health and education resource for the future. However, we have been clear and I want to be clear again today in the chamber that while we are supportive of NHS Western Isles exploring the opportunity, we do not wish that to create any delay in the submission of the full business case for the health centre. Alasdair Allan. I thank the cabinet secretary for that very helpful answer. Will she acknowledge that people in Barra have been waiting a very long time for NHS Western Isles to provide a replacement hospital? I will be in Barra this Friday and I know my constituents there will want to be reassured that in whatever form this project is realised, any changes will not delay the submission of a full business case or indeed the Government's commitment to provide a new hospital by 2021. I am very happy to give Mr Allan that absolute assurance. I have asked my officials to provide me with an update on where we are between the submission of the outline business case about 10 months ago and what I would expect to see as a full business case very shortly. Should there be any particular hiccups or hitches in that, I will expect my officials to intervene and assist that health board to produce that full business case at the earliest possible opportunity so that we can make good our commitment and those assurances that I know we have given many times. It is time now for us to ensure that they are delivered. Annabelle Ewing. To ask the Scottish Government whether it will provide an update on out of our assertion care in NHS Fife. Fife health and social care partnership are in the process of carrying out further work with the communities and key stakeholders across Fife following the meeting of the integrated joint board on 20 December, where the decision on the future of out of our services was postponed until the community participation requests had been answered. I understand that NHS Fife expect to communicate with community groups on that matter as soon as possible, and I have been asked to be kept informed. Annabelle Ewing. I thank the cabinet secretary for her answer, but as the MSP for County Beath constituency I would stress that overnight out of our urgent care at the Queen Margaret hospital in Dunfermline, as well as in Gunrothys and St Andrews, has been suspended for nearly 11 months now. Could the cabinet secretary therefore use her good offices to ensure that Fife health and social care partnership now resolve matters in the interests of individuals and families in Fife? I am grateful to Ms Ewing for her supplementary question. As she knows, I was very concerned in December that the integration authority might take what I considered to be a precipitative decision. I am grateful that it has postponed that and undertaken the further work that I think was required. I am very keen to assure her that I am taking a very close interest in this matter. I understand that a progress report and a number of the outstanding issues will be given to the IJB meeting in April. I am assured that some progress has been made, including, for example, the introduction of a new remuneration rate for GPs, which has supported an increase in the number of GPs providing regular sessions. In addition, continued support and investment in nurse training and the use of paramedics is improving resilience in the short and longer term. I absolutely understand the need for consistency and resilience in the service, and my officials will continue to work with Fife health and social care partnership during this period, and I will ensure that I am kept regularly up-to-date. Alexander Stewart, to be filled by Claire Baker. I ask what steps is the cabinet secretary taking to ensure that staff shortages will not lead to further centralisation of our services in Fife? I am very clear that there are a number of issues that the health and social care partnership need to address to ensure that there is as reasonable as possible equity of access to out-of-hours services. I had the benefit of some discussion with GPs from St Andrew's in terms of the propositions that they had put and their consideration of what might be appropriate and possible there. All those matters are in my mind as I look to continue to be updated on how they are going in that health and social care partnership in terms of the consultation and the final set of propositions that they want to bring forward. I take Mr Stewart's point. I do not believe that it is entirely a matter of staff shortages, and I have already outlined some improvements in that regard. I think that it is about understanding what is most suitable for those local communities. In terms of what we touched on earlier, issues such as transport and so on, ease of access to some of those out-of-hours facilities. That is what I will be looking for when I see their final proposals. Claire Baker, to be filled by Jenny Gilruth. The cabinet secretary may be aware that December 2018, so the highest number of patients attend the downscaled out-of-hours services, which is based in Cercodia and Victoria. That is higher than any time over the past four years. Does the cabinet secretary agree with me that those numbers illustrate the demand for the service? She am I concerned that this centralisation disadvantages communities who live out with Cercodia and earlier she talked about rural distances and I hope she recognises that Fife does come into that category. Notwithstanding what she has already said, does she commit to supporting NHS Fife to increase the pool of GPs who will work out of hours? I understand an advert that was put up at the end of last year that had no applications at all for a post that was advertised for GP out of hours and Fife. I hope that Ms Baker is assured that I understand the issues that she is raising. I understand the point about remote and rural areas and having travelled in Fife looks like a relatively compact area on a map. It is precisely my point, but travelling those roads is less straightforward than perhaps in other parts of our country. There has been some work to increase the number of GPs who are prepared to work out of hours but also to look more widely at, as I spoke about in earlier questions, to the wider professional skill mix that would be appropriate for out-of-hours services, not least some of our increased enhanced paramedic facilities as well as advanced nurse practitioners. That will be what I am looking for in the mix to ensure that we have as far as possible equity of access to out-of-hours services across the kingdom of Fife. That is what I will be looking for when that health and social care partnership comes forward with their proposals. Jenny Gilruth I ask the cabinet secretary if she is able to update members on the transport appraisal for Glynorthus hospitals, GP out-of-hours service to assure my constituents that access to transportation at the Victoria hospital has been assessed appropriately. I am grateful to Ms Gilruth for her question. Obviously, if I had advanced notice of that, I would have ensured that I had that information. I do not have that information and I am happy to forward it to her. Bill Kidd To ask the Scottish Government what action it is taking to support the upgrade of sports pitches in Anisland to 3G multi-use game areas. Minister Joe FitzPatrick The Scottish Government routes plans and applications for upgrading and maintenance of sporting facilities through Sport Scotland, the national agency for sport. Sport Scotland is not aware of any current proposals for pitch developments in Anisland area, however we will be willing to discuss potential applications from clubs and or community groups seeking support. Bill Kidd I thank the minister for that response. I know that the Scottish Government has been proactive in supporting upgrades for sports in primary schools, including in my Anisland constituency. Can I ask the minister to confirm whether the Scottish Government will work with Glasgow and other councils across Scotland to provide further progress in ensuring that secondary schools also make the upgrade to 3G pitches? Bill Kidd I thank the member for his answer. I understand that Glasgow City Council has asked Glasgow Life to lead a review of the existing pitch strategy in Glasgow. That is focusing on the same sports as their existing strategy, such as football, rugby union, rugby league, hockey, cricket, tennis and basketball. That review is looking at the strategic supply of and demand for pitches across the city. Of course, the focus of Glasgow Council is on increasing provision of grass and synthetic pitches across the city. Sport Scotland would be very happy to discuss that matter further with Glasgow City Council. Neil Bibby To ask the Scottish Government whether it will provide an update on infection control measures at the Royal Alexandra hospital and NHS Greater Glasgow and Clyde. I am grateful to Mr Bibby for the question. Can I start my answer by passing on for the record my sincere condolences to the family and friends of the individual who died as a result of contracting, forgive me, stretofomus maltopphilia infection? When an outbreak or incident is identified by a board, an incident management team is established to assess and manage a situation. Clearly, the specific control measures required to prevent further cases and ensure patient safety is tailored to the nature of the bacteria identified and how it is spread. NHS Greater Glasgow and Clyde has worked with Health Protection Scotland to ensure that those additional appropriate infection control measures have been put in place and remain in place for the incidents that are reported across NHS Greater Glasgow and Clyde, including the Royal Alexandra hospital. Neil Bibby I thank the cabinet secretary for that answer. Yesterday, Healthcare Protection Scotland published a report on a recent inspection at the RAH, which found staffing gaps in the domestic cleaning rotor and issues with the maintenance of the estate. This is very concerning and comes after recent serious infections across the health board area, including, as the cabinet secretary said, a bacterial infection in the RAH hospital that contributed to the death of one patient. Does the cabinet secretary believe that the standards of cleanliness found in the report are sufficient? What is the Government doing to ensure that our hospital environments are maintained and that there are no staffing gaps in domestic cleaning rotas? The cabinet secretary is absolutely correct in terms of his analysis of what that report said. I take that very seriously. I was very concerned to read about those gaps in the cleaning rotor and the maintenance, because, of course, cleaning and domestic services and maintenance are critical elements of infection prevention and control. My officials, including the new director general for health and chief executive of NHS Scotland, are in daily contact with NHS Greater Glasgow and Cloud, picking up on those matters, checking the additional work that they are doing to ensure that they address those concerns. I have a daily update to ensure that I am kept up to date with that, too, and I am pursuing some of those issues directly with them. In terms of other health boards across the country, as we have done, we seek assurance with them on the data that they have on their staff numbers, on domestic and cleaning work and maintenance, and on where we are identifying what we consider to be unacceptable gaps. There is no immediate plan to fill those gaps, and we are pursuing that with those health boards in order to ensure that they do precisely that. They look to ensure that they have all those vacancies filled as far as they possibly can. Murdo Fraser To ask the Scottish Government what action it is taking to ensure the full reopening of the pitlockery minor injuries unit. I have almost given up on you two, Mr Fraser, but never ever. The pitlockery minor injuries unit can and opening hours are Monday to Friday between 9 am and 4.30 am. Outwith those hours, appropriate out-of-hours services, including a nurse or a GP, can be accessed through NHS 24 by calling treble 1. The Perth and Cynros health and social care partnership is continuing to run a recruitment exercise to appoint additional staff with the specialist skills required in order to support the full opening hours of this minor injuries unit, which, as I understand it, was from 9 am to 9 pm. Murdo Fraser I thank the cabinet secretary for that response. She will know that the minor injuries unit at pitlockery is now closing at 4.30 on a weekday and has been closed at weekend for some months now, which is causing a great deal of frustration to residents in Highland Pressure, who faced the alternative, a long journey to the nearest alternative, which is in Perth. What specific action can the Scottish Government take to support NHS Tayside to try and find replacement staff to try to ensure that that important local facility is reopened to the full extent? Ruth Davidson Our work continues with NHS Tayside to look at the detail of the particular problems that they are addressing and whether or not there are additional measures and steps that they can take in order to improve their opportunity to recruit the staff that they need and whether or not they are looking as widely as possible at what should be the appropriate staff mix. We continue to have those discussions. It is important that members understand that, where we are aware of situations such as this one, which has gone on for some time, we directly get in touch with the relevant health board and the local health and social care partnership to understand the detail of what they are doing and suggest to them in ways that have been tried elsewhere and have been most successful, that they might look to adopt or additional measures that we as a Government may be able to assist them with. Therefore, we are continuously in that work with Perth and Cunroth's health and social care partnership and with NHS Tayside, and I am happy to update the member on the detail of what we have been doing. The Deputy Presiding Officer Thank you very much, and that does conclude portfolio questions. We are going to move on in a few moments' time to the next item, which is a debate on the Hutchison hospital transfer and dissolution bill. We will just take a few moments for the members and Minister to change seats.