 Before we move on to the next item of business, members will wish to join me in welcoming to our gallery the right Honourable David Carter MP, Speaker of the New Zealand House of Representatives. We now come to Topical Questions, number one from Mark Ruskell. I declare an interest as a councillor in Stirling and ask the Scottish Government how it plans to support local authority action to reduce air pollution. Cabinet Secretary for the National Party, Roseanna Cunningham. The Scottish Government is already working closely with local authorities as they implement their air quality action plans, providing both practical and financial assistance. An additional £1 million to support this important work is being provided in 2017-18. Mark Ruskell. I thank the cabinet secretary for that response. Clearly finance is important. This is a public health crisis. There are three and a half thousand people in Scotland dying every single year because of these air quality problems. Will the government commit to providing funding specifically for low-emission zones? I am sure that the member does not want me, as the cabinet secretary, to tie local government's hands when we give funding over. He will be well aware that there is a considerable debate about that. The funding that currently exists allows them £1 million for action plan measures, £0.5 million for monitoring, £0.5 million for roadside emissions testing and £1 million to support wider air quality resources. That has been added to by a further £1 million in the 2017-18 budget. Developing low-emission zones is a matter for discussion within the Government and will require local authorities to come forward with their ideas in respect of that. At that point, I would consider what might or might not be required at what stage in order to deliver a low-emission zone. There are a number of components of any financing of that, as the member is probably as well aware. Mark Ruskell. I thank the cabinet secretary for that further response. I hope that we can get some clarity on the exact package of low-emission zones. In addition to the 38 areas that breach their quality limits, there are also many other areas where particularly NOx emissions and particular emissions are creeping up. We know that there is good evidence on 20-mile-an-hour speed limits that they can significantly reduce air pollution from diesel vehicles. Will the Government also consider a default 20-mile-an-hour speed limit across Scotland's residential areas, which should be significantly cheaper for councils to roll out than the current piecemeal approach to 20-mile-an-hour zones? If I could make a few comments about low-emission zones, first of all, we expect there to be an initial low-emission zone in place by the end of 2018. That is what we are working towards. A great deal of water has to go under that particular bridge before it is in place. It will be interesting to see how many of the campaign commitments that get made in the coming April-May campaign relate to potential bids to be the location for a low-emission zone. On the secondary question of the specifics about 20-mile-an-hour zones, I am sure that the member is perfectly well aware that I would be not within my portfolio remit if I started indicating for somebody else's portfolio what detailed policies they should bring forward. It may be that he will wish to raise this again on Thursday, after the statement in terms of the climate change plan. Maurice Golden Thank you, Presiding Officer. My constituents in Johnston and Renfrew will have been alarmed to read that their town is one of the worst places in Scotland for air pollution, according to Friends of the Earth Scotland. Parents will especially be worried about the harm that may cause their children. Unfortunately, there are only 10 air quality monitors, half of which are broken, available to share between every school in Scotland. Will the cabinet secretary consider extending access to air quality monitors for Scotland's schools? I have a look at that specifically and get back to the member on the very particular question that he is asking about. I know that there are monitoring units in a number of different places and, in respect specifically of schools, I will check where we are with that. Obviously, local authorities are doing a great deal across Scotland to try and help the situation. It is local authorities who have the statutory obligation to regularly review air quality in their areas and to bring forward plans to deal with that. As well as raising the issue within the chamber, I hope that he is also raising it directly with the local authority concerned. To ask the Scottish Government whether the Scottish Ambulance Service is meeting its response time targets in rural areas. I know that the proficient of ambulance services in the Highlands and Islands is a matter of concern to the member and his constituents. I understand that the member will be meeting with senior Scottish Ambulance Service manager soon to discuss those concerns. In 2015-16, the ambulance service reached 65.5 per cent of its category, and it calls within the eight-minute target against a steadily increasing patient demand. That does not mean that other patients face long and extensive delays. Despite the increased demand, ambulance service crews are saving the lives of more patients than ever before. The average response time for potentially life-threatening calls remains at around 7.4 minutes. While time targets are clearly important, they do not in themselves measure the quality of patient care or patient outcomes. Neither do they take account of advances made in clinical development of pre-hospital care in recent years. That is why the Scottish Ambulance Service is piloting a new response model that was announced in November last year. The model has been developed following the most extensive clinical review of its type of undertaking in the UK, with nearly half a million call-outs examined. That will benefit patients in urban, rural and remote communities in Scotland. The Scottish Government and the Scottish Ambulance Service are both committed to ensuring that patients across Scotland receive the best care possible. That is why we have invested in an extra £11.4 million in the Scottish Ambulance Service for 2016-17, which will include the recruitment of 200 extra paramedics as part of our commitment to training 1,000 more paramedics over the next five years. The funding will help to improve care across Scotland, including in some of our most remote and rural communities. Edward Bowden I thank the cabinet secretary for that answer. Although it does not resolve all the problems, I would like to remind the cabinet secretary that, on 24 November, I raised the issue with the First Minister of her mum, who went through labour in an ambulance on the way from Caithness General to Regmore hospital. Both Ali and I promised to report on that, and we still await that. On Christmas Eve, I raised the issue with the cabinet secretary of Thomas, a young child who waited over 10 hours for an ambulance from Caithness General to Regmore. I have received an acknowledgement but no detailed response. Today, on 17 January, I want to raise the issue of two mums who had to travel from Regmore in labour in horrendous condition. In one case, the snow gates were closed, which meant that two attempts were needed to get her to Regmore in a private four by four before she got through. What is clear to me and the people of Caithness, I believe, is that NHS Highland management model for Caithness hospital is not working. Will she join me, therefore, and the latest convert to the cause, which I am delighted to welcome, Gail Ross, with asking for a full management review of hospital provision in Caithness, and an ambulance provision to support that before this whole situation spirals further out of control? Can I first of all ask Edward Mountain to ensure that the detail of any individual patients that he has raised are sent on to my office? Of course, the senior managers that he is meeting with would be keen to discuss with him any individual patient issues. It is important to get to the bottom of any individual patient cases that have been raised. In relation to Caithness, I am obviously very aware of the fact that NHS Highland has taken the very difficult decision to make the changes to obstetric maternity services at the hospital, and, of course, the chief medical officer has kept in close touch with the progress being made. Obviously, as the member knows, that decision was made on patient safety grounds. Although there is no consultation on the issue because of the decision being taken on patient safety grounds, I have made clear that it is very important to keep local people in touch to allow them to contribute to some of the discussions around the need to strengthen services, not just within the Scottish Ambulance Service but in Rakemore as a receiving hospital for those cases. It is very important that we deliver safe and high-quality services to pregnant women and newborn babies in Scotland, and that, when adverse events happen, we reflect on the lessons to ensure that they are never repeated. We want to make sure that all women receive the best services. That is why we initiated a review of maternity and neonatal services across Scotland, which now has reported to me and will be published shortly. I would expect managers within NHS Highland to ensure that the services that they deliver for any women and newborn babies across any area of the Highlands are in line with the outcomes and recommendations of the maternity and neonatal services report. I will make sure that Highland follow-up on that under the guidance of the chief medical officer. There is time for some additional brief supplementaries. Mr Mountain, do you want another supplementary? I think that, Presiding Officer, the supplementary, I guess, for Cathness is how services in Cathness can ever equate to the rest of Scotland, where immediately you have a 100-mile trip under blue lights for mums who are in labour to get to Rakemore, especially in conditions where there are snow gates closed and inability for helicopters to get there. I do not understand how the cabinet secretary believes that it will be the same for the rest of Scotland when Cathness is very different by its very remoteness. Perhaps she could answer that. First of all, I am sure that the member will appreciate that if a report after an adverse incident says that a service is not safe, that is not something that anybody can ignore, whether that is me as the cabinet secretary for health or managers within NHS Highland. That would be extremely irresponsible of them to have ignored a report that said that that service was not a safe service. If you look across the Highland, there are many services that are midwife-led services that are again being delivered in remote and rural areas. What is important is the infrastructure and the protocols that are there to ensure that the Scottish Ambulance Service is responding in the way that it needs to ensure that it is safe transfer of women and that that should happen at the right time and early enough. Importantly, the receiving hospital in this case, Rakemore, has the facilities there to ensure that women and their families are catered for in a comfortable and welcoming environment. He will be aware, because he will have had quite a great deal of local briefing around that, that a lot of work is under way to ensure that that happens. I can assure the member that I am keeping a very close eye on the situation in Highland standing cave next, as is the chief medical officer. I would like to ask what range of options are available to the Scottish Ambulance Service when faced with adverse weather conditions. Well, adverse incident calls are assessed and if access to a remote patient is identified, then the service will assess their capabilities to respond either through their sort team, those who undertake specialist training to drive off-road or indeed the Air Ambulance Services. If that is not possible due to availability of resource or severe weather conditions, then the Ambulance Service would seek assistance from partner organisations, whether that is the MOD or HM Coast Guard aircraft. In certain circumstances, a vehicle such as the Polaris may be requested by a partner organisation such as Police Scotland. It is very difficult to argue with patient safety and the reason for changing the way a service is delivered. However, I have asked NHS Highland and I will ask the cabinet secretary today what risk assessment has been undertaken of the alternative of taking women down in labour to Inverness when the appropriate vehicles are not available to take them. NHS Highland is no locus over the Scottish Ambulance Service, but the cabinet secretary has. Will she take steps today to make sure that there is adequate provision in Caithness to take women in labour down to Inverness on an ambulance or, indeed, by helicopter, but certainly not in the back of a vehicle when snow gates are closed? First, I welcome the fact that we would have grant recognises the patient safety issues raised about the service at Caithness general, which left senior managers within NHS Highland a very difficult decision to make. It was not one taken lightly, I can assure her. I have made it very clear that the expectations around the service delivery to pregnant women and their newborn babies in Highland relies as much on the Scottish Ambulance Service response as it does on NHS Highland. I can assure her that there has been very close working and collaboration between the Scottish Ambulance Service and NHS Highland. In fact, I have asked for regular updates from both organisations to ensure that they are working together to ensure that not just the safe transfer of women and, in fact, any other patients requiring transfer takes place, but that, indeed, the receiving hospital, Rhaigmore, has the facilities that are there in quality for not just the women but their families as well. I am very happy to keep Rhoda Grant and, indeed, any other member updated on that, but I can assure her that the role of the Scottish Ambulance Service is critical. The cabinet secretary may be aware that one fact that was influencing response times in Murray was the use of emergency vehicles for inter-hospital transfers between Dr Grayson Elgin and ARI in Aberdeen, which is now thankfully being addressed by a new post to coordinate better use of the emergency vehicles and non-emergency vehicles, so that the emergency vehicles are available to answer 999 calls. Will the cabinet secretary be willing to ensure that her officials closely monitor the progress of that change to ensure that it is being effective and to see that any further interventions are required? I am happy to agree to do that. The Scottish Ambulance Service has an urgent tier vehicle based in Elgin, which can be used to safely transfer patients who do not need any ambulance. As the member has just alluded to, the service is also recently invested and deployed to specialist paramedics in Elgin. They cover Elgin and the surrounding area and provide an enhanced response for patients. The service is able to now manage a range of clinical needs in the area, including treating patients at home, referring patients or conveying patients to hospital. I am certainly happy to keep Richard Lochhead informed of the development of that service.