 The first item of business this afternoon is portfolio questions and, as ever, in order to get as many people in as possible, short and succinct questions and answers would be preferable. Question 1, Cameron Buchanan. To ask the Scottish Government, when it last met representatives of the NHS boards, national health boards. Cabinet Secretary, Alex Neil. Presiding officers and senior officials meet regularly with representatives of NHS boards to discuss issues of interest to the people of Scotland. Can the cabinet secretary confirm whether there have been any discussions regarding the use of robots in the surgical treatment of prostate cancer, following prostate cancer UK's highlighting that it can deliver better outcomes than other forms of surgery? Moreover, given that England has now 33 of these robots and Scotland none, can he advise why they are available in England but not in Scotland when they will be available in Scotland and what arrangements are in place to ensure that the Scots can use the English facilities on the NHS in the meantime? There have been extensive discussions on the use of robots in prostate operations, particularly in the west of Scotland and in the Grampian area. The national planning group is looking at this in great detail, including what lessons can be learned from America where there is much more extensive use of robotic surgery. It will report in due course and I will update the Parliament at that time. When did the Scottish Government last meet Lanarkshire health board and have they received an update on the norovirus outbreak at Hermeyrs, which has closed two wards and restricted places to patients in four? Has also led patients been sent away and directed to wish general? If you have, can we also receive the update in the chamber please? Presiding Officer, we are in regular touch with NHS Lanarkshire about the very exceptional outbreak of norovirus, the extent of the outbreak of norovirus in Hermeyrs hospital, which has led to some disruption in terms of the provision of services. I have to say that this is an unprecedented and scale outbreak of norovirus in Hermeyrs and the action taken by NHS Lanarkshire has been about the safety of patients and indeed the safety of staff. I will ask NHS Lanarkshire to make sure that all Lanarkshire MSPs are updated as soon as possible on the current situation and kept up to date with any further changes. To ask the Scottish Government what action it is taking to address waiting time challenges in NHS Lothian. I am aware that the board has been experiencing capacity difficulties delivering the waiting time guarantee and standards. That is why the board has already indicated that it will be investing more than £8 million in the current year to increase capacity by recruiting around 80 full-time equivalent staff, including consultants, nurses and other clinical support staff in specialities such as ENT, ophthalmology and orthopedics. That additional capacity will come on stream soon and should enable a significant reduction in waiting times over the coming months, with the 12 weeks legal treatment guarantee being delivered by the end of this year and the outpatient waiting time standard by March 2015. My officials will continue to work closely with the board to support delivery of waiting times. I thank the minister for his reply and particularly the commitment for his officials to work closely with NHS Lothian. Minister, the NHS Lothian struggles to meet the targets. It is one of the worst performers on both 18 and the 12-week targets and is spending £1.5 million on private procedures every month. Will the minister accept that there has been a serious capacity problem, despite the best efforts of the staff, and that the sheer demand of patients needing treatment must be addressed to shift the resource into this area of NHS Lothian will inevitably impact on other areas? Is the minister confident that NHS Lothian has the resources to meet the increasing demand and capacity that it is currently challenged with meeting? I am absolutely confident that the minister has the money to do that without adversely affecting other areas, because there has been a real-time increase in NHS Lothian's board this year, and it will also have a real increase in its budget for next year. The fundamental problem in NHS Lothian is particularly around Edinburgh, where the capacity planning that was done 10, 12 or 15 years ago grossly underestimated the growth in the population in Edinburgh by up to 20 per cent. As a result of that, NHS Lothian has had to invest in additional capacity in the Victorian elsewhere to cope with the demand for day-to-day services as a result of that under-planning of capacity that happened in previous years. I am absolutely confident that it has a very workable plan that will be delivered, and by the end of this year—I have always made this clear—I expect NHS Lothian to deliver the TTG for in-patients and, by March next year, the TTG for out-patients. To ask the Scottish Government what action it has taken to promote healthy 18 choices for children. Minister Michael Matheson. We are taking forward a range of activities to support children to eat a healthy balanced diet from nutritional standards for school meals to our £3 million food education fund to teach children about the food that they eat and the impact that it has on their health. Last week, I launched Beyond the School gate, which offers guidance on how we can positively influence the food environment around schools. It builds on better eating, better learning, which was published in March, which sets out refreshed guidance to support further improvements in school food and food education. Together, it offers a holistic package to help partners to support children to make healthier choices both inside and outside school. The First Minister announced earlier this year that the entitlement to free school meals would be extended to all children in primary 1 to 3 from January 2015, thereby supporting the development of healthy eating habits for at a young age. I thank the minister for his reply and welcome to the Scottish Government's recent Beyond the School gate announcement among others. Clearly, it is important that local authorities do all that they can to ensure healthy options for children. Does the minister share my disappointment however that the local authority that we share, Falkirk Council, has failed to sign up to previous initiatives such as seafood and schools and will do all that he can to encourage Falkirk Council and others to embrace those healthy eating initiatives more positively? I am sure that the member will recognise that everyone has a part to play in trying to help to encourage school children to eat a balanced diet and a healthy diet as best they can. That includes those in the retail sector, in local authorities and in particular education departments and in other agencies that can help to support in achieving that. I am aware that Falkirk Council has not proceeded with the seafood and schools programme, which I share his disappointment on. I encourage Falkirk Council to do so to reconsider that matter, because encouraging children to eat seafood is an important part of having a balanced diet. I think that that was a very positive initiative that Falkirk Council could take forward. Is the minister aware of the responsible retailing of energy drinks campaign that has been recently endorsed by the EIS? The campaign in Scotland is led by councillor Norma Austin Hart and seeks to encourage retailers not to sell energy drinks to children, building upon the Scottish Labour ban of the sale of these drinks within schools. Consuming energy drinks means that children come to school, often agitated, often unable to concentrate and learn and can be disruptive in class. Indeed, the wider health implications are not really known. Retailers, especially those close to schools, are being asked not to sell these drinks to young people under the age of 16. I wonder if the minister would now back the campaign to ensure that children come to school ready to learn and are not disruptive. There are a number of important factors that have to be taken forward in trying to encourage school children to remain within the school environment for eating and part of that. It is about the type of food that is provided within schools and there is a range of work that has been taken forward by local authorities to encourage and achieve that. The school that I visited last week saw a 40 per cent increase in the number of children who have remained in school to consume food in schools because of the approach that they have taken. The second part is to work with those retailers that are in close proximity to their school gates to look at what action they can take. As I set out in the guidance for local authorities, the measures that they can take for their own licensing in order to address some of those issues. A combination of those factors is extremely important. The issue about beyond the school gate is not just fizzy drinks, it is foods that are high in fat, sugar and salt that have a significant impact on the health of children. We have to deal with all those factors, not one in its own, if we are going to try to deal with that issue in a comprehensive way. Our calls on local authorities have a key role to play in helping to deliver that through the policies that they can take forward in a licensing form. To ask the Scottish Government what measures it is taking to combat malnutrition, which affects some of the most vulnerable older people. The Scottish Government is doing many things to tackle malnutrition for older people. 1.75 million pounds since 2008 to improve nutritional care for older people, including malnutrition screening of all patients when they are admitted to hospital, nutrition champions in every NHS board and introducing protected meal times. Scotland was the first country in the UK to make screening for malnutrition a mandatory requirement. The care inspector had expected all care for older people and support plans to detail specific food likes and dislikes. 2 million pounds from 2012 to 2015 to community food in Health Scotland to promote healthy eating in the least-privileged communities has been made available, improving food access and awareness of nutritional guidelines towards tackling health inequalities. 3. Scotland's national oral health promotion training and support programme, caring for smiles to improve the oral health of older people, particularly those living in care homes, is another initiative that we are supporting. I thank the cabinet secretary for that response. However, there is a worrying lack of data about older people in Scotland who are malnourished. In fact, the estimated figure of 100,000 malnourished older people in Scotland comes from projecting UK data. Is the cabinet secretary aware that, although age concern welcomes the must screening initiative that he referred to, it is concerned that there is no screening of malnourishment of older people in the community, and furthermore, although screening occurs when older patients are admitted to hospital, the 2013 HIS report was critical about the effectiveness of the screening and the limited information about patients' nutritional needs in five hospitals that it inspected. Does he consider that there is now a compelling argument for more data on the issue to properly assess and address the problem that is in hospital, care homes or involving older people living in the community? In terms of the HIS report, we are implementing the recommendations. In terms of data, the estimate that we have is something up to 30 per cent of older people admitted to acute hospitals are at risk of malnutrition. Between 30 per cent and 42 per cent admitted to care homes are at risk, 10 per cent to 14 per cent of the 700 of the people in sheltered accommodation may be at risk. 14 per cent of older people are at risk of malnutrition altogether over the population. We have got a fairly good handle on the scale of the problem, but outwith hospital, we need to do more. I agree to tackle this problem. The best way is to ensure that older people have the necessary income so that they can afford to buy the food that they need to sustain themselves. That is extremely important. We are very supportive of the proposals to improve the pension for older people, many of whom, particularly women, have a very low income indeed and find it difficult sometimes to buy the food that, of course, is increasing in price all the time that they need to stay wealth malnutrition. To ask the Scottish Government what steps it is taking to increase community involvement in the pharmacy application process in remote areas. I am pleased to say that I announced in the 30th of May the laying of amendment regulations that will ensure that there is direct community engagement and participation in the consideration of pharmacy applications. The new regulations will also ensure greater transparency in the decision making process so that people affected by decisions have a better understanding of how and why those decisions are taken. Mike McKenzie. I thank the cabinet secretary for that answer. It is becoming increasingly difficult to recruit and retain health professionals in remote areas. What support is the Scottish Government providing to health boards to tackle that issue and support local accessible health services? I assure the chamber that the Scottish Government recognises the current challenges in remote and rural areas and is committed to ensuring that all communities in Scotland receive high quality and sustainable healthcare services. In particular, the Scottish Government continues to promote a range of initiatives to recruit and support GPs working in remote and rural areas. Those include proposals for a specific programme of work to be taken forward by NHS Highland to develop and test a range of innovative ways of delivering healthcare in rural parts of Scotland. That will involve exploring approaches to building sustainable health and care services with all key stakeholders, including local communities. We welcome the changes to community involvement in pharmacists and look forward to receiving more of the detail. Can I ask what steps the cabinet secretary is going to make to make sure that people in remote rural areas access pharmacy services? Since Sky recently, where Macmillan Boots and NHS Highland are working on a pallid of care community pharmacy project, which works really well and really underlines the need of pharmacy services, not just to GPs working in rural areas, but their patients as well. It is primarily a responsibility of each board to ensure that pharmacy services are accessible through every part of their geography. I am very well aware of the initiatives that are taken by NHS Highland, which I think will be very successful. We wish to roll out those initiatives that have been proven to work to other parts of rural Scotland. To ask the Scottish Government what progress the NHS is making in recording and reducing the levels of boarding out. The Scottish Government is leading the way in the UK to tackle boarding. Health boards record and monitor boarding levels on a daily basis, and we have put a range of initiatives to reduce boarding. Those include our £30 million unscheduled care programme, the integration of health and social care, our commitment to seven-day working, the development of a bed planning toolkit and a programme to improve patient flow and reduce boarding and other delays to treatment. However, there is more to be done and we will continue to work to improve the quality of care in our hospitals. Since the boarding out system was introduced at the monitoring of it under Nicola Sturgeon, we have undertaken a freedom of information inquiry. That has shown the number of patients being boarded out between 11 pm and 6 am in the morning was 10,500 in 2011-12, 12,712 and 13,000 for the full year last year. If that was not bad enough, the shocking figures are only derived from seven out of 14 health boards. Lothian, Tayside, Glasgow and Clyde Grampian could not even produce figures for movements at that time. Similarly, we asked about multiple moves and five large health boards, Lothian, Lanarkshire, Greater Glasgow, Tayside and Grampian, were unable to say how many multiple moves has occurred. Can I ask the cabinet secretary whether he is really satisfied with the management of boarding out and whether the boards are not even recording the information? Will he issue an instruction now for the boards to comply with recording, including times, and to include a cross-reference to the presence of cognitive impairment, a group that he and I would both agree are least able to cope with boarding out? Will he invite the health improvement Scotland to make it part of its inspection regime? The figures that Dr Simpson quotes relate to the work that we have done with the Royal College of Physicians and others and the substantial report that was produced on boarding last year. I accept that there is far too much boarding going on, particularly with people with cognitive problems. The whole purpose of that report and its recommendations that we are implementing is to improve the situation, both in terms of recording, but, most importantly, to reduce the need for boarding in the first place. I will certainly take on board the additional suggestions that Dr Simpson has made. Question 7, Gordon MacDonald. To ask the Scottish Government what steps it is taking to tackle health inequalities in the most deprived communities. As a Government, we have been clear that health inequalities in our most deprived communities cannot be solved by health solutions alone. The interventions that are most likely to reduce health inequalities of those that utilise taxation, legislation, regulation and changes in the broader distribution of income and power. We have demonstrated our commitment to this approach with measures such as free prescriptions, free eye examinations, expanding free school meals and the provision of childcare and our work on youth employment. We will continue to take forward a range of policies that will assist in tackling health inequalities in partnership with our colleagues within the NHS, local authorities and third sector. Gordon MacDonald. I thank the minister for that answer. I read in the press recently about a pilot scheme referring to a GP link worker who can help people to deal with financial, emotional or environmental problems as a result of housing, debt, social isolation, stress or fuel poverty issues. Can the minister provide more details of that pilot scheme? The pilot scheme that the member makes is a reference to what was launched by the cabinet secretary just in the last few weeks, which is a partnership that has been developed with several of the deep end practices. It is a pilot project that will see a link worker being placed within seven of those practices in Glasgow and in Dundee with a number of eight comparator practices to evaluate the effectiveness of the link worker. Their purpose will be to look at what support they can provide to patients that are referred to them by GPs. It can be relating to housing, finance or our environmental issues. This is a pilot that we have worked with the deep end practices on developing and taking forward and it will be evaluated over the next couple of years. The initial intention was that that programme would be for a two-year pilot. However, following discussion with the deep end practices themselves, we have agreed to extend that to five years. What we will do is take the learning from that as we go forward over the next five years to see how we can then extend that out to other practices in the private areas. To ask the Scottish Government what action is taking to help young people with cancer access clinical trials. The chief scientist of the Scottish Government funds several research networks of which two, the Scottish Cancer Research Network and the Scottish Children's Research Network, operate to enhance access for children and young people with cancer into clinical trials. CSO has entered into discussion with those two research networks to ensure that they work closely to provide support to patients in this transitional age range to take part in clinical research. Aileen McLeod. I thank the cabinet secretary for his answer. Given the importance of accessing clinical trials and helping to treat young people with cancer, can the cabinet secretary advise what progress is being made with the recruitment of a new cancer clinical research champion when he expects the announcement of such a new champion to be made and how this champion will tackle the inequity of access for young people into clinical trials? Presiding Officer, I am pleased to be able to tell the member and the chamber that, after a competitive recruitment process, Professor David Cameron—no relation, I do not think, to another David Cameron—of Edinburgh University has been appointed as the new Scottish Cancer Research Champion and a formal announcement will be made in the near future. In its early discussion with Professor Cameron, the chief scientist's office will ask him to look into the issue of access to trials for young people with cancer and to obtain reliable data. To ask the Scottish Government when it will review the standard mortality rates at Ayr hospital. HSNR figures for all acute hospitals in Scotland, including University Hospital Aeol, are routinely considered on a quarterly basis. The next figures will be published in August 2014. The latest data available to the quarter-ended December 2013 indicated that there was a national reduction of 14.2 per cent in hospital standardised mortality ratios in Scotland since recording such data began in the quarter-ended December 2007. The data for Ayr hospital indicated a higher single data point on this quarter's analysis. Although HSNR cannot be used in isolation, as a marker of quality and safety of care, it can be used as a smoke alarm to trigger further evaluation. As a result, NHS Ayrshire and Arm are already undertaking further investigation of this data point, and Healthcare Improvement Scotland are engaged in a supportive process of dialogue and interaction with the board. Healthcare Improvement Scotland and the Scottish Government will continue to work with NHS Ayrshire and Arm to ensure that their HSNR continues to fall in accordance with the national trend. I thank the cabinet secretary for his very comprehensive answer. Against a background where standard mortality rates across Scotland have, as he said, dropped by 14 per cent since 2007, it is regrettable that Ayr hospital in the last recorded quarter was above the national average. That should not hide the fact, however, that Ayr hospital and its staff have a good longer-term record in reducing standard mortality rates. Despite what has been a serious economic recession, specific problems such as increased methadone deaths and deaths as a consequence of social issues such as energy poverty are being addressed, it would ask that the Government ensures that the hospital continues its drive to improve the appropriate standards of quality of care that reduces the levels of mortality. Presiding Officer, the Scottish Government expects all health boards as part of the Scottish patient safety programme to implement measures to prevent avoidable harm and deaths. The Scottish Government is committed to further improving the safety of healthcare and expects NHS Ayrshire and Arm to continue to improve the quality and safety of care for the population that it serves. I will keep a very close eye on it to make sure that it does. Presiding Officer, the cabinet secretary is aware of the shortage of available beds at Ayr hospital that may or may not have influenced the standard mortality rates. Can the cabinet secretary tell Parliament what can be done to better manage bed availability at Ayr hospital, which is key to reducing A and E waiting times? There are two specific areas that affect the issue of beds in Ayr hospital. One is delayed discharges, although South Ayrshire is relatively, by far, not one of the worst authorities in dealing with delayed discharges. Secondly, the flow of patients during the day is still too high a percentage of patients who are being discharged each day are discharged fairly late in the day, for no good reason, quite frankly. A key part of implementing our unschedule care plan for all hospitals, including Ayr, is to improve dramatically the percentage of patients who are discharged before lunchtime as they are medically fit for discharged, and it is appropriate to free up the beds for those people who are coming in through the A and E department and, indeed, through GP referrals. To ask the Scottish Government when it last met the NHS Greater Glasgow and Clyde board. Both ministers and Government officials regularly meet representatives of NHS Greater Glasgow and Clyde to discuss matters of interest to the people of Greater Glasgow and Clyde. As the cabinet secretary is aware, patients in North and North East Glasgow and beyond who require chemotherapy more often than not have to make their way to the Beatson Centre to receive such treatment. That is often not a very easy journey, particularly by public transport, and is an additional difficulty for people who are perhaps already unwell. Can the cabinet secretary indicate, if he has discussed with NHS Greater Glasgow and Clyde, the possibility of chemotherapy being provided at Stop Hill hospital, saving the patients involved, a great deal of stress and anxiety? I am very well aware of the issue, and I have been in touch with many of the people from North of the River who are very keen to establish those services at Stop Hill. I have studied both the information provided by Greater Glasgow and Clyde, as well as by those people campaigning for this change. I have to say that I think that Greater Glasgow and Clyde are taking the right decision in that matter, but I am happy to share the information with the member, and indeed I am happy to meet the member, along with representatives of Greater Glasgow and Clyde health board, so that we can discuss the issue in detail, because it is a very very detailed issue in terms of the statistics about the postal code areas where people come from for such treatment. I wonder if the cabinet secretary could confirm, as a result of his discussions with the health board, what arrangements or contingencies they have made to cope with a large international presence in the city during the Commonwealth Games and how they intend to ensure that those attending have access to information should the need arise? Can I say to the member that the health service, like all other essential public services, has been part of the resilience planning for the Commonwealth Games? The health board has played a very full part, along with the organising committee for the games with Glasgow City Council and with a range of other bodies, to ensure that we have in place all contingencies and arrangements to meet all contingencies during the Commonwealth Games. I am happy to write to the member with more detail of those, although for obvious reasons I cannot always give him too much information, because some of it, by the very nature, has to remain confidential. To ask the Scottish Government what measures are being taken to improve early identification and diagnosis of children with asthma. The Scottish Government is committed to providing the best quality of care and treatment for people with and living with asthma in Scotland. Health Improvement Scotland published last year asthma priorities influencing the agenda. That includes the early and accurate diagnosis of asthma in children. John Wilson. I thank the cabinet secretary for his response. I have further asked the minister what work is being undertaken with GPs regarding the issue of asthma and referrals to specialist asthma services. What is the availability of asthma treatments, particularly looking at the development of new treatments for young children, especially for those children under the age of four? The member will be aware that there was a recently published national review of asthma deaths that looked at the way in which asthma services were being delivered across the whole of the UK, including here in Scotland. There is a range of recommendations contained in that particular report. There are key aspects in terms of the way in which services are delivered at a primary care level. For example, there is the issue of making sure that there are regular reviews undertaken of a patient who has been diagnosed with asthma and making sure that they are encouraged to participate in that review. There is also about making sure that they are receiving the appropriate preventative medication as and when appropriate and that it is being used appropriately. What is now happening is that, given the recommendations that are being contained in that report, the national advisory group on respiratory managed clinical networks is considering all the detail of the recommendations to consider what actions we need to take in Scotland in order to improve services yet further. With regard to specific treatments as well, I am sure that the member will appreciate the nature and type of treatment that a patient is prescribed is a clinical decision. We would expect whether it be general practitioners or clinicians in the secondary care setting to make sure that, particularly children who require a particular form of treatment for their asthma, that that is provided to them timely and in an appropriate way. I thank the minister for his response and for his addressing the asthma deaths problem. I wonder if what he is doing in terms of the recommendation to look at those patients who have prescribed more than 12 reliever inhalers in a year, because those are the ones where they reckon that there are higher levels of deaths. What monitoring system is he putting in place to ensure that those people are picked up quickly and are reviewed? I recognise the point that the member is making. That is why the national advisory group on respiratory managed clinical networks is considering those recommendations in particular. Once we have received their report and recommendations on what measures should be taken forward, including aspects of monitoring, if that is what they recommend, we will then consider how that can be rolled out on a national basis. However, there is an issue about making sure that there is a greater consistency of approach in the way in which we are managing conditions such as asthma. I think that the national review provides us with very helpful information on how we can achieve that more effectively. To ask the Scottish Government what its position is on the health impact of overprovision of licensed premises in urban areas. The provision or overprovision of licensed premises within a local area is a matter for local licensing boards to consider. One of the grounds for refusal of a premises license is that the granting of it would result in overprovision having regard to the number and capacity of existing premises. In assessing the extent of any overprovision in a locality, the board must consult relevant interests, including the police and the local health board. I thank the minister for that answer. In central Edinburgh, there is an outstanding planning application for a 900-seat superpubs currently under appeal. One chain is looking at converting three properties into large new pubs, and last month two new supermarkets were controversially licensed against the advice of NHS Lothian and the police. What advice would the minister give to local authorities and licensing boards on how they should weigh up the advice that they receive from health and law and order interests against other interests to ensure that we can tackle the problem of overprovision and overconsumption of alcohol, especially in city centres? There is a very well-established evidence that demonstrates that availability is a key factor in driving alcohol consumption overall. It is a type of factor in which boards should be taken into account when they are submitting their evidence to licensing boards and their view on the potential health impact that any further provision of licence premises could have. The member will appreciate that it is a matter for the local licensing board to ultimately make a decision on that matter, but I encourage licensing boards to make sure that they consider in detail the responses that they receive from their colleagues within individual local health boards and to consider that in any decision-making that they are making around the provision or the overprovision of licence premises within their local authority area. To ask the Scottish Government how unpaid carers could be supported by the findings of the expert working group on welfare. The Scottish Government currently provides significant support to unpaid carers underpinned by a considerable investment of nearly £114 million since 2007 within its existing powers. The expert working group on welfare is clear that, with independence, we can go further in supporting this vital sector. We have already committed to raising carers allowance to the rate of job-seekers allowance if we are the Government in an independent Scotland, as recommended by the group. The report outlines some of the longer-term measures to support unpaid carers, addressing disincentives to work and caring in the benefit system and in the workplace, and tackling the current rules limiting study and receiving carers allowance. As the First Minister said in the chamber last week, the Government will take forward and consider fully the recommendations of the expert working group. I thank the minister for that answer. Have we recently met a representative of the Scottish Youth Parliament to discuss their care fair share campaign? It is clear that those issues that the working group outlined as affecting carers, such as low income and variable levels of support, are also challenges that can face young carers. Has the Scottish Government looked at any additional assistance for young carers, for example in the area of education maintenance allowances? I am aware of the report that came from the youth parliament in Scotland regarding a range of work that we have taken forward, particularly in the area of education, to try to help to support young carers to remain in education, because it is important that they are able to do so, whether that be in the primary setting, the secondary setting or the higher and further education setting. We have also taken forward work with the college development network to look at what policies individual colleges can put in place to help to support young carers in their education. We have also recently issued new guidance around education maintenance allowances in order to make sure that the needs of young carers are accommodated in the way in which colleges assess EMAs. Those combination of measures, I believe, can help to support young carers in their education setting, but there is clearly more that we can do, and we are considering what further measures can be taken forward with carers legislation in the coming years. Question 14, John Mason. To ask the Scottish Government what its position is on prescribing homeopathic medicines. Presiding Officer, the strategic direction and funding for healthcare in Scotland is set by the Scottish Government. Decisions on the allocation of funding to provide access to services, including complementary and alternative therapies, is a matter for the individual health boards based on the needs of their local populations and in line with national guidance. The prescription of specific treatments is a clinical decision for practitioners. John Mason. Is it becoming more difficult to get homeopathic medicines? Obviously, a number of boards have carried out a review. There is one going on in Lanarkshire at the moment, and Lothian, I believe, has carried out one recently as well. Clearly, in different parts of the country, there are different approaches to the availability of homeopathic medicines. Sometimes there is confusion between access to homeopathic medicine and access to the services of the centre for integrated healthcare in Glasgow. The centre for integrated care provides a much wider range of services, very effective in efficacious services than just homeopathic. Although it is referred to very often as the Glasgow homeopathic hospital, it provides many other services of a holistic nature and not just homeopathy. I would make that distinction in answering the member and bring to the attention of the chamber the excellent provision of services by the centre. To ask the Scottish Government what secondary dental treatment for oral cancer is provided without charge by the national health service in Scotland. All dental treatment for oral cancer should be provided free of charge where a patient is referred to hospital dental services. The care should be provided as part of a consultant-led medical treatment plan. It should also be the case that failure to provide the care would impact detrimentally on the patient's medical condition or prospect for recovery. On discharge, and once the oral cancer team are content, the surgery and treatment has been completed, the patient's condition is now stable, then the patient would be returned to the care of their dentist. Dr Smith? I thank the minister very much for that answer. I was made aware by a member of the public who told me that he was fundraising for an individual who had been told that he needed to have dental extractions that were not covered, although he had also been advised that they were required as part of his treatment. I am very grateful to him for setting that out. Although the individual is not my constituent, I am not pursuing it through case work, I am grateful for him. Is he confident that that guidance is being followed by every board in Scotland? There are different stages in the course of treatment that any patient may require if they have been identified as having oral cancer. If the member is referring to some pre-operative work that may be required, including dental extractions, as part of that process, that would be part of the consultant-led medical treatment provision as part of the treatment plan for that patient. If it is being provided by the public dental services, it would be free of charge. However, if the member has specific details that he wants to provide me with, I am more than happy to make sure that that is thoroughly investigated because any patient who is receiving medical-led treatment for oral cancer should receive their dental treatment free of charge. Thank you minister. That concludes questions and brings us to the next item of business. I will allow a few seconds for members to change places.