 The next item of business is portfolio questions and I'll say it again in order to get as many people in as possible. I want short and succinct questions and answers to match. I'm in a good mood at the moment. Number one, Fulton MacGregor, please. Thank you, Presiding Officer, and to remind the chamber and the PLO to the health secretary to ask the Scottish Government how it ensures that the voices of young people are heard during the development of mental health services. Thank you, Presiding Officer. When we published our mental health strategy in March 2017, engagement and co-production with young people was a consistent theme. I valued the opportunity to hear young people's views first-hand through the work that we carried out in conjunction with the Scottish Youth Parliament, Young Scott, Children in Scotland and many others. Those views were crucial to informing the final strategy. We continue to put young people's voices at the heart of the strategy and have several strands of on-going work that directly involve young people. Those include the Scottish Youth Commission on Mental Health, run by Young Scott, a review of PSE in schools strategy action 1, an audit of rejected referrals to CAMHS, being run by SAMH strategy action 18, work on transitions between CAMHS and adult services, being run by the Scottish Youth Parliament strategy action 21. All of that work is really valuable, and particularly so, given that 2018 is the year of young people, we will continue to ensure that young people's voices are heard and acted upon, particularly as mental health is consistently mentioned as one of the top priorities for young people, if not the top priority. Pulton MacGregor. I thank the minister for that response. A couple of weeks ago, I held a round-table meeting with the Children and Young People cross-party group, where a whole range of stakeholders contributed to the subject of mental health and young people. A particular focus was given to that transition period that the minister mentioned from CAMHS to adult services between the ages of 16 and 18. How is the Government ensuring that young people have a say in the services that are available for that particular group? I thank the member for his interest in the issue. It is good to hear that there is a focus on transitions between CAMHS and adult services. That is also one of the central themes that emerged during the Scottish Youth Parliament's Speak Your Mind campaign on mental health, which has been so crucial to informing our strategy. As I mentioned in my first answer, the Scottish Youth Parliament is taking forward work on transitions and we want to focus on the use of anticipatory care plans and how they can be best used to support young people who transition between CAMHS and adult services and between different CAMHS services or, indeed, out of CAMHS altogether. The youth Parliament's work will ensure that the final anticipatory care plan has been designed to buy young people for young people. It held a discussion day event on 24 March, which I attended, and I am looking forward to the final product being finalised and rolled out in the coming months. In Dumfriesen Galloway, we have seen a 10 per cent rise in the number of temporary staff working in children and adolescent mental health. Does the minister agree that that represents a huge challenge for running child-centred services and what action is the Scottish Government taking to address it? The key is early intervention and prevention. Yes, we are seeing increasing numbers coming forward for CAMHS, but we also want to make sure that people are appropriately referred. If it is not the CAMHS specialist intervention that is required, the intervention at tiers 1 and 2 is also available. 2. Richard Lyle To ask the Scottish Government how the digital health and care strategy will help to deliver person-centred care. Scotland's digital health and care strategy, which was published last month, highlights the opportunities that technology offers to empower citizens to better manage their health and wellbeing, support independent living and gain access to services through digital means and to support a shift in the balance of care. The external expert panel highlighted that Scotland is an international leader in technology-enabled care, and our strategy sets out an ambition to widen and extend such services. Richard Lyle How does the digital health and care strategy contribute to the on-going work on the integration of health and social care in our communities? Does she agree that the use of a mix of technology and traditional methods is key to delivering sustainable care now and in the future? The strategy recognises the benefits of a focused approach to delivery and the eight national health boards' new collaborative approach to offering improvement and transformational change, while working along with the Scottish Government and COSLA, the local government digital office, the Scottish social services council and the care inspectorate, is going to be key to delivering on those ambitions. That is not about technology necessarily being the solution, but wider service transformation will bring together expertise and knowledge with technology integral to helping that change to happen. Anas Sarwar Thank you, Deputy Presiding Officer. Cabinet Secretary, we will cover some of this later, but what consideration has been given on the use of technology in crisis mental health situations, so that people can have rapid access to a counsellor or a psychologist to avoid them having a really tragic circumstance? Cabinet Secretary Of course, there are already services such as reading space that provide very important services to those who are suffering from a crisis. NHS 24 has also been involved in providing services that people can use online, which have been well evaluated. There is probably more that we can do in that space, particularly for people who are living in more remote and rural communities. That is something that I am certainly keen to explore. Patrick Harvie To ask the Scottish Government what work it is doing to assess and reduce the health impact of air pollution. The Scottish Government takes the issue of air pollution very seriously and is committed to the protection of the public health from the effects of poor air quality. Compared to the rest of the United Kingdom and other parts of Europe, Scotland enjoys a high level of air quality, but we cannot be complacent about this. Our clean air for Scotland strategy sets out an ambitious programme of action to promote air quality. Scotland is the first country in Europe to pass legislation based on world health organisation guidelines for fine particulate matter. We are also providing practical and financial support to local authorities in tackling local air pollution hotspots. Plans are underway to have Scotland's first low emission zone in place in Glasgow by the end of 2018. The situation, particularly in Glasgow, is not as rosy as the minister said. Scotland has great air quality. There are areas of Scotland that have consistently, over many years, failed to meet basic air quality standards. As someone who lives in one of those pollution hotspots, I agree with the Opposition councillors who have called for a more rapid implementation of the low emission zone than the one that the council proposes. That is a council decision, but what support will the Scottish Government give to Glasgow City Council to assess the difference in health impact that will be achieved from that more rapid implementation of the LEZ that the Opposition parties are calling for in Glasgow? We are working with local authorities around low emission zones. I do not think that it is overstating the fact that, compared with the rest of the UK and other parts of Europe Scotland enjoys high levels of air quality. I never suggested that we are not working hard to ensure that we can do more where we can. We are absolutely not being complacent. £10.8 million in funding has been allocated this financial year to support the implementation of local low emission zones with a particular focus on set-up costs and bus retrofit, for example. We will continue to work with our local authorities' partners to make the improvement that we need. Kenneth Gibson, briefly please. Thank you, Presiding Officer. Around 1.5 million people smoke in Scotland and cigarette smoke contains more than 4,500 compounds. Those include acetaldehyde, carcinogen, acetone, which damages the liver and kidneys and ammonia, accords of asthma and high blood pressure. Does the minister agree that, if we are serious about breathing clean air, we must continue to do everything possible to persuade people to quit smoking? Yes, absolutely. We must continue to do everything possible to persuade people to stop smoking. Our efforts in Scotland on smoking rates have been bold and progress to make has been good. We are also among the first in the world to set a tobacco-free target by 2034. Quitting is the best thing a smoker can do to improve their health, and we would encourage any smoker to try to quit their own way and to make use of the free stop smoking support available to them. I also point the member to the quit your way campaign that we have taken forward to ensure that people understand the many different ways they can get support to help them to quit the habit. Clare Adamson, to ask the Scottish Government what impact it expects that the minimum unit pricing of alcohol will have on health. Last week saw the introduction of a minimum price of £0.50 per unit of alcohol. The University of Sheffield modelling estimates that, in the first year, that will result in 58 fewer alcohol-related deaths and nearly 1,300 fewer alcohol-related hospital admissions. In over a five-year period, we could expect 392 fewer alcohol-related deaths and 8,254 fewer alcohol-related hospital admissions. The monitoring and evaluation plan for minimum unit pricing being led by NHS Health Scotland includes examining the impact on alcohol-related harms. Clare Adamson, thank you for your answer. The recent figures in 2016 in North Lanarkshire show that there were 122 alcohol-related deaths, causing NHS North Lanarkshire to unestimated £116 million. I am very pleased to hear the cabinet secretary say that minimum unit pricing should go some way to reducing those. Will the cabinet secretary agree with me that the minimum unit pricing model that Scotland is introducing is one that other countries will be paying close attention to, with a view to rolling out elsewhere? The Welsh Assembly introduced legislation for minimum unit pricing of alcohol in October last year. The Government of Ireland's Public Health Alcohol Bill includes a provision for minimum unit pricing and passed the second stage in the lower house in March this year. On Tuesday, the Parliamentary Undersecretary of the State and Social Care, Steve Brine, MP confirmed that the UK Government is commissioning Public Health England to review the evidence for minimum unit pricing in England. I also understand that the Australian Northern Territories are considering a minimum floor price for alcohol. I think that it is a landmark policy that other countries around the world are watching Scotland with interest. The cabinet secretary is well aware that the Parliament has already passed the social responsibility levy, and it is up to the Government whether it is implemented. Will the cabinet secretary look at that levy again? That could help fan third sector groups at local level to try and help to fight the problems that are caused by drink-related problems. The additional revenue that was predicted by Sheffield University is very much an estimate. We will, through the evaluation, see where any additional revenues fall. It is important that, as we explored at the health committee, we understand where that falls. The social responsibility levy was always considered to be a local mechanism to address local circumstances, but, as I said at the health committee, those are things that we will keep under review as the policy goes forward. I am happy to keep members informed about that. The Scottish Government, what discussions it has had with Fife Health and Social Care Partnership, since its decision to suspend overnight out-of-hours services in Dunfermline, St Andrews and Glenrothes? The decision to move to contingency measures for the provision of the out-of-hours service in Fife was taken for reasons of patient safety. Officials are in regular contact with Fife Health and Social Care Partnership regarding those measures and the on-going situation. Following the closure of the out-of-hours services, the director of health and social care highlighted growing difficulties securing clinical cover of both GPs and nurses as a result of national shortages. In Fife, those are well-known difficulties, with many practices struggling to get GPs during the day, never in mind at night. Does the cabinet secretary accept the Government's responsibility in creating this situation? Given those concerns, is she confident that the services in Dunfermline, Glenrothes and St Andrews will reopen in two months' time when they are up for review? As Clare Baker knows, the changes to out-of-hours primary care services are a short-term measure that was in the interest of patient safety. As I said in my initial answer, NHS Fife are reviewing their longer-term arrangements for out-of-hours care and have undertaken an option appraisal exercise. A public consultation will commence in June prior to any permanent decisions being made, and we will continue to lize with NHS Fife throughout the review process. Clare Baker talked about the issue of GP recruitment. Obviously, there are some significant issues in Fife with GP recruitment and retention. We believe that the new GP contract, along with the £110 million investment in primary care in this year alone, will help to make general practice more attractive and will help to build on the local innovation over the past few years. Through the Recruitment and Retention Fund, for example, we think that that will be of assistance to local areas seeking to recruit. I should also say that the workforce plan, which has recently been published, has a commitment to an additional 800 GPs over the next 10 years. The cabinet secretary shared my concerns that no quality impact assessment was carried out prior to the temporary closure of Glenrothes hospitals out-of-hours service. Particularly given that that was a key recommendation of the richer review and given that one in three children in Glenrothes live in poverty. I understand that an equality impact assessment was not completed due to the emergency nature of the contingency arrangements. The contingency arrangements were put in place as a result of clear clinical advice. Although a formal equality impact assessment was not carried out, I have been advised by the Fife health and social care partnership that the impact on various communities and groups was part of the decision-making process in terms of the contingency. Equality impact assessment has been completed in relation to the longer-term plans for the service, and that will continue to be updated. To ask the Scottish Government what funding packages are in place to meet the expenses of people who have to travel considerable distances to access healthcare, including outside their NHS board area. There are a range of options available to patients who require financial assistance with travel costs. That includes the Scotland-wide patient travelling expenses scheme for those on qualifying benefits and the Highlands and Islands travel scheme, which provides assistance to all those living in remote areas. In addition, all health boards have the discretion to reimburse patient travelling expenses, where it is viewed to be an extension of treatment costs and deemed to be clinically necessary. She will be aware that some people in Caithness, Sutherland and Ross have had to travel for miles to access specialist care in Rhaigmoor hospital in Inverness, some having to take days off work, often for minor appointments. Can she tell me how the introduction of the videoconferencing near me service will change that, and will we see it rolled out to other remote and rural areas? The NHS near me uses the nationally available attend anywhere video consultation service funded by the Scottish Government's technology-enabled care programme. That provides a secure video consultation environment for any service delivery organisation and can be accessed anywhere by a member of the public using a web browser or app on their laptop, tablet or smartphone. In Highland, near me has had an initial focus on supporting the Caithness area whilst developing the service, but it is now working closely with the Scottish Centre for Telehealth and Telecare to roll that out into further areas in that region. An uptake of the service continues to increase and can prevent people from having to travel unnecessarily. Given that we are 18 months post a major service redesign in Caithness hospital, does the cabinet secretary believe that 200-odd mothers and their families travelling to the maternity unit at Rhaig Mawr should be provided with suitable accommodation at the hospital, which, sadly, is still below what was agreed as being suitable? Edward Mountain will be well aware of the reasons for the change of status of Caithness maternity unit being made by NHS Highland on the grounds of safety informed by the review that it commissioned after the death of a child in September 2015. In terms of the issue of Rhaig Mawr and making sure that accommodation is suitable, that is an issue that has been raised with NHS Highland on a number of occasions to impress upon them the importance. I understand that they have taken action to make improvements on the Rhaig Mawr site, and that is something that I will continue to press them on. To ask the Scottish Government what action it has taken to consult people in remote and rural areas on the impact of the new GP contract. The Scottish Government commissioned health and social care alliance Scotland to engage with patients across Scotland, including those in rural areas, on the new contract. The alliance will publish a report on that engagement soon, which will provide valuable feedback to local health and social care partnerships that are currently developing their primary care improvement plans. Those plans set out how the new GP contract will be implemented locally to best meet the needs of patients. A contract based on the number of appointments does not take account of travelling time for rural GPs. They have more home visits due to the lack of public transport in rural areas, where frail elderly people cannot come to the surgery. The contract shows no recognition whatsoever of the difference in rural practice. Neither does the Scottish index of multiple deprivation, which is used, show rural deprivation, meaning that rural GPs are missing out again. The Scottish Government has not heard the rural GPs far less their patients. How are they going to rectify the situation and ensure that everyone has access to a GP going forward? The Scottish Government, in collaboration with the Scottish General Practitioners Committee of the BMA, is establishing the rural short-life working group, which will work with rural stakeholders to help to assist in the implementation of the new GP contract. I understand that the first meeting of that group will happen later on this month. Liam McArthur Thank you very much for following on from that response. Given that the cabinet secretary advised Parliament on the time frame for that short-life working group, will she also ensure that there are island representatives on that short-life working group to reflect the specific issues that arise in island communities? Cabinet secretary? Yes, I can say to the member that, as I reiterated in my last answer that the group will meet later this month, there has been a lot of effort put into looking at the membership of the group and, as I understand it, there is island representation on that group. I am happy to write to the member with further details of who they are. To ask the Scottish Government how it ensures that quality is embedded and evidenced in drug and alcohol services. Minister? In 2014, we developed the quality principles, which define the standards that people can expect when using a treatment service. Those principles put the person at the centre and build a recovery plan around their strengths. In 2015, the Government commissioned the Cairns Spectre to support alcohol and drug partnerships to evaluate service quality against those principles. We were assured that quality was embedded in our services and that they worked for recovery, but there is always room to do more, and local improvement plans are in place to evidence that. Is the minister aware of the high-quality coffee solace in my constituency? A huge part of its success comes from taking a whole population approach to tackling challenges faced by our community and tackling food poverty and providing people with recovery a way to build skills and give back to the local people. Will the minister join me this summer to visit coffee solace and meet with peer mentors and see first-hand this high-quality coesla gold-winning work? I am absolutely happy to meet with the member and to visit and to learn more about this excellent work. I understand that coffee solace also won last year a coesla excellence award, so I am absolutely happy to come to the member's constituency and see first-hand the work that they do. I have been very fortunate to visit a number of recovery communities across Scotland, of which there are now over 120. To have the opportunity to speak to many people for whom those communities act as a foundation of the recovery from drug and alcohol use, community initiatives are incredibly important, so I would absolutely welcome the opportunity to see the good work happening in the member's constituency. Today's global drugs survey showed the extent of drugs use in Scotland, where users have taken more cocaine in a single session than anywhere else in the world, and delivery is the drugs quicker than a pizza. I am coming across more and more people who are very seriously affected by their mental health and their physical health by cocaine use. If we are looking at evidence-led drugs policy, then is this evidence and the level of drug deaths in Scotland not evidence enough that our policy is failing? We have made a number of advancements through the current strategy. We have a low number of young people taking drugs—there is a declining number of people taking drugs—but I absolutely recognise the member who makes drugs. I know that he is shaking his head, but I absolutely recognise the point that he makes about the issue that we have seen in the press today about cocaine. I absolutely recognise that every year we see the drug deaths. That is why I have taken the decision to refresh our current approach to build on the strengths that we have existing in Scotland, but to do more to recognise the change in landscape of drug use in Scotland. If the member wants to bring to me some constructive ideas, then absolutely—my door is absolutely open, as opposed to continually criticising from the sidelines. It is an important issue. I do not want to get hung up on party politics on this, so please come to my office, meet with me, tell me your ideas and we will make sure that they are part and parcel of the new strategy that I am taking forward. To ask the Scottish Government whether it will provide an update on the implementation of its mental health strategy. I will present an annual report on the strategy's actions to the Scottish Parliament in the summer. Progress reports for all 40 actions in the strategy were uploaded to the Scottish Government website in December. We also uploaded a report summarising progress on key deliverables in December. I would be happy to provide the member with links to those reports. Additionally, we held the second biannual forum of stakeholders on 6 December. The forum is intended to track progress on the actions in the strategy and to help to develop new actions in future years to help to meet our ambitions. I spoke at the meeting in December about our achievements over the previous half year, the challenges ahead and the roles for everyone involved going forward. I was contacted by a pressure group from Mackie academy in Stonehaven who were concerned about the support available for teenagers and children struggling with mental health issues, particularly relating to the lack of training in GPs with some children being told that they were going through a phase and asking that training in mental health be included as part of teacher training for early intervention. Given that early intervention is so vitally important, can the minister outline how funding for the mental health strategy is being targeted in that regard and are measures such as having on-site councillors or cpns in schools actively being considered? I completely agree that focusing on prevention and early intervention is fundamentally important if we are to achieve the vision and aspirations of our mental health strategy. Training has a central role to play in this, and that is why action 2 in the strategy, for example, is to roll out improved mental health training for those who support young people in educational settings. Since 2014, the Scottish Government has provided £6,000 per annum to Education Scotland to roll out Scotland's mental health first aid training for children and young people to local authorities. The aim of that is to train staff within secondary school communities in order to increase their confidence in approaching pupils who they think might be struggling with a mental health problem. That training will complement a range of mental health strategies that are already in place within local authorities. To ensure that the mental health strategy 2017 to 2027 is delivering for people, it would be beneficial to know when each action should be implemented. Can the minister tell me why the strategy has very few timescales attached to the action set out? As the member rightly said, the strategy is for over 10 years. Some actions have already been implemented, but, on the Scottish Government, we certainly have a timeline for each strategy, and I monitor that closely to see how each action is progressing. I can provide the member with further details on that if she wishes. To ask the Scottish Government what its position is on concerns regarding the overuse of antidepressants. People experiencing mental ill health should expect the same standard of care as people with physical illness and should receive medication if they need it. The prescription of any medication, including antidepressants, is a clinical decision made in discussion with the patient, and there is good evidence that health professionals assess and treat depression appropriately. We are also committed to improving access to alternatives, such as psychological therapies, that increase choice and best accommodate patient preference. The Scottish Government supports services provided by breathing space and NHS living life to people experiencing depression, and is a key element of wider work across Scotland to intervene early and prevent problems from becoming worse. That aligns well with our policy on improving prevention and intervening early, which is one area of focus for our new 10-year mental health strategy. The number of children under 18 being prescribed antidepressants doubled from 2,748 in 2009-10 to 5,572 in 2016. Although that might reflect an increase in the demand for child and adolescent mental health services, it potentially highlights a worrying reliance on pharmacological solutions to mental health. Does the Scottish Government not agree that 10-minute GP appointments, combined with a lack of appropriate mental health services, is leading to an over-dependence on pharmacological solutions that is having a devastating impact on countless lives across Scotland? As I said to my member in my first answer, the prescription of antidepressants is a clinical decision, and it is not for Government to intervene in clinical decisions. The importance is to have alternative therapies and to have quick responses to young people who have mental health problems. That is why, in the shift towards more emphasis on primary care, we are making sure that counsellors are available early, instead of people having to wait longer in CAMHS services. However, I am also making sure that CAMHS services are moving towards meeting their waiting-time targets. To ask the Scottish Government how it supports participation in sport in the Renfrewshire South constituency. The Scottish Government remains committed to encouraging more people to take part in sport and physical activity at all levels. Sport Scotland invests directly in East Renfrewshire and Renfrewshire Council, which covers the parliamentary constituency of Renfrewshire South to support a number of programmes and outcomes in club sport in coaching and volunteering. For example, in 2016-17, there were 412,000 visits to active school activities across East Renfrewshire and Renfrewshire, and there are now 11 community sports hubs up and running. Barhead Youth Football Club has recently expanded the number of girls teams at various age levels, which I know are already hugely popular. Will the minister join me in congratulating Barhead YFC on its fantastic work? Can she outline how the Government supports opportunities for girls and women to participate in football? Absolutely. We will join the member in congratulating the work that is going on in Barhead. All the work that is going on across football at the length and breadth of the country, we had the opportunity a couple of weeks ago to celebrate some of that good work in the Parliament and to recognise the real effort that has been made to ensure that women get the chance and girls get the chance to participate in the beautiful game. Our girls' game is the hashtag that is used, so if anybody has got the chance to look at the Twitter world, they can see just exactly how much fantastic work is driven by a number of volunteers supported by the SFA and others to make sure that girls get the chance an opportunity to play football. I ask the minister if she is working on delivering us her physical literacy pathway, which would include pre-school physical activity and into-school physical education, and on into the third sector and communities, where we make sure that the opportunities to that access are as easy as they possibly can be for sport and physical activity. We are actively working on a physical activity plan and absolutely making sure that all ages and stages and all efforts and policies at those ages and stages are linked appropriately into the work that we are taking forward. For instance, the work that is on going around play makes a very good link into the work that we are wanting to take forward to ensure that young people in particular get the co-ordination skills, the fine motor, gross motor skills that they require to enable them to either continue to be active or to participate and proceed into sport at all levels. We hope that they will be on the podium, like the member once was a few years ago. To ask the Scottish Government when it last met Greater Glasgow and Clyde health board. Ministers and Scottish Government officials regularly meet representatives of all health boards, including NHS Greater Glasgow and Clyde, to discuss matters of importance to local people. There is a campaign in my constituency to have an outpatient chemotherapy service at Stalpool hospital, as was originally planned when the new hospital opened in 2010. Does the cabinet secretary agree that this service, where appropriate, should be available closer to home to avoid patients having to make tiring journeys before and after treatment? I am familiar with the campaign and have indeed met some of the campaigners in my constituency. I understand that the expert clinical view is that local people are best served by receiving treatment at the specialist beats and oncology centre in Glasgow. That said, I know that the health board has assured local campaigners that they will keep the service under review to consider what other local provision would be possible and appropriate. To ask the Scottish Government what plans it has to ensure that all eligible men in Scotland receive an MP MRI before a prostate biopsy. Multi-parametric MRI scans are currently being tried to examine the feasibility and safety of them as a diagnostic tool in men with prostatic disease. The initial results of the study indicate that MRI could be used as a diagnostic tool in the future and might, in time, decrease the need for traditional prostate biopsies. Our national advisory group, such as the national cancer clinical services group, will keep studies such as that in mind when developing future cancer services in Scotland. Mark Griffin. I thank the cabinet secretary for that answer. In December 2016, the cabinet secretary announced the formation of a urology cancer services review, recognising that prostate cancer is the most common cancer among men. It will be the most common cancer in the country by 2030, but that review has not reported back yet. In September 2017, the cabinet secretary also created the ministerial cancer performance group, but it will not report back until the urology service review reports back. Can the cabinet secretary say when the urology service review will report back and if the adoption of the MP MRI has been included in the scope of that review? I will write to Mark Griffin with an update on the timeline for the urology services review that he has asked for. Getting urology right in Scotland is very important, because that is where the most difficulties in recruiting is to urology services. It is one of the challenges around the delivery of cancer targets at the moment. The urology service review is one of the most difficult. I will get back to him on the timeframe for the services review. In terms of the MP MRI question, I answered him my first answer that really this is being looked at as a study at the moment to make sure that we gain the clinical evidence. We would rely on groups such as the national cancer clinical services group to advise on whether that should be rolled out. Again, I am happy to keep Mark Griffin updated as they come forward with further information. To ask the Scottish Government what action it is taking to ensure that all NHS boards provide out-of-hours dental care. The responsibility for ensuring access to out-of-hours emergency care for patients registered with a dentist under the NHS rests with their dentist. The Scottish Government has provided additional funding to NHS boards to put in place out-of-hours services with appointments being triaged by NHS 24, in line with national clinical guidance. The specific arrangements for providing any required out-of-hours care for patients who have been triaged are for the relevant NHS board, in conjunction with practitioners who have the responsibility towards their patients. Being from a rural constituency, many of my constituents understand my need to make some travel to reach health appointments. However, a constituent of mine was told two weeks ago that the only available out-of-hours dental care was at a centre that would require a 110-mile round trip. Cabinet Secretary, we look into ensuring that out-of-hours dental care can be made available but does not require such a lengthy journey. I am aware that NHS Grampian is conducting a review of the out-of-hours dental care. No decision has been made at this stage, but the board is currently looking at how to deliver the most effective service provision for patients, so I will make sure that the member is kept informed of the outcome of that. Mr Scott, you have managed at this time your patients. Is it number 16, Tavish Scott? To ask the Scottish Government in light of the reported comments by the health secretary regarding co-operation between NHS boards that there will be a regional structure in place, whether it will provide further details of this policy and what the implications are for regional NHS boards. We have been clear that there are no plans to reduce the number of territorial health boards. Our focus is on ensuring better joint working between NHS boards and other partners through more effective regional planning of services. As part of the three regional implementation leads that have been selected from the existing cohort of NHS board chief execs, working with NHS boards and their partners, they are leading the overall design and planning of services at a regional level to provide better patient outcomes and more efficient and sustainable services. That must be brief. I am grateful for the clarification. Is the shuttle health board in the north area that she described, is there a regional plan and has that been submitted to the Government and when will it be published? We have had draft plans from the regions and they will be embarking over the summer with public engagement to discuss some of the detail of those plans and, hopefully, Tavish Scott will have the opportunity to attend one of those events. Thank you. That concludes Portfolio Questions. I am still in a good mood.