 Fyniadwg. Fy enw i'n gweithio'r cwestiynau swyddfa diolch gynhyrchu'r cwestiynau ac'r cwestiynau swyddfa diolch gynhyrchu'r cwestiynau a'r pethau socialiaiddig, fyddwn i'n gwneud i hyn o gwithio'r cwestiynau sesynau mewn plwy yn rhoi'r a chinese heb byddwn i'r cwestiynau niad o'u afael hefyd neu oedd y cwestiynau swyddfa am yn y cwestiynau wedi'r cwestiynau, dyrwng i'r cwestiynau a gwinodau. I would like to ask the Scottish Government what specific training and continuous personal development GPs undertake to remain updated on developments in helping women through peri-menopause and the menopausal stages of their life. Minister Marie Todd. Menopause is included in the Royal College of General Practitioners curriculum, which all GPs trainees need to demonstrate competency of in order to practice independently as a GP in the UK. Team materials and aids are widely available to GPs to ensure that they remain updated on the latest developments in helping women through both the menopause and the peri-menopause. The Scottish Government has recently commissioned at NHS Education Scotland, NES, to create a bespoke training package and framework focused on the menopause and menstrual health for GPs and others working in primary care. Jim Fairlie. I would like to thank the minister for that answer. When I spoke to numerous constituents about their concerns and their experience of menopause, the experiences have been patchy and inconsistent in the information and help that they have been offered. Some have been completely dismissed as being either too young to be suffering from peri-menopause or told that menopause is not a disease, so therefore just getting through the process until it is unbearable is probably the best course of action. I could cite numerous examples of very poor outcomes for women who have felt completely dismissed about the changes that they are experiencing in their lives. Dr Louise Neeson, who is a practice in GSP herself, had to set up her own menopause clinic because no one seemed to be able to give her the correct treatment for her. I ask the minister to please look at what GPs in Scotland are doing to advance the understanding and care that peri-menopause and menopausal women are going through so that they get the individual person-centred treatment that suits their specific needs. I thank the member for that question. Indeed, women have told us very loudly and clearly that they do not always get the support that they need when they are seeking help from menopause symptoms. In fact, that is one of the reasons for my having women's health responsibilities specifically in my portfolio. It is also why, through the implementation of the women's health plan, we intend to build a basic understanding of menopause amongst all healthcare professionals. That will include awareness of the symptoms of peri-menopause and menopause and the intermediate and long-term consequences of menopause, knowing where to sign post-women for consistent advice and support. We have created, in the last year, a menopause specialist network that has been established and it meets regularly and supports primary care teams by providing access to a menopause specialist for consistent advice, support and onward referral, leadership and training. I would expect to see improvements. It is right that we need to consider all ways of helping women through peri-menopause and the menopausal stages of their life. However, to spearhead the policy and advocacy work in that regard, we must appoint a women's health champion here in Scotland. The First Minister told the chamber in June that an appointment would be made in the summer. Charities are now saying that this deadline has been missed. Will the minister advise if the Scottish Government has made an appointment and if not, why not? Let me assure the member that that appointment process is almost complete and I would expect to be able to make an announcement around the appointee very soon. Of course that was, indeed, as I have reiterated many times, a medium-term commitment in the women's health plan. We have met all of our short-term commitments in the women's health plan and we are making progress on many of the medium-term commitments that we made. I want to ask about the accessibility of HRT supplies. While trying to access my own medication, I have faced barrier after barrier and inconsistency after inconsistency. I have seen the protocol and it is nothing more than a scrap piece of paper. Let me ask what action is the Government taking to stop menopausal women and peri-menopausal women from being bounced around the primary care health service so that they and we can access the support and treatment that they need in a timely and straightforward manner? Before I ask the minister to respond to that, I would highlight that the question on the business bulletin relates to the issue of specific training and CPD. If the minister could respond to the question in that light, that would make the question supplemental to the question that is on the business bulletin. Thank you, minister. I am absolutely happy to do that. There is prescribing guidance available to assist prescribers from multiple sources, including from Nice. They revised their menopause prescribing guidance in March this year, and that can be found in the usual places of clinical knowledge summary online. I would have to say that Scottish Government ministers and officials are unable to comment on individual cases of prescribing practice because it is NHS boards and healthcare professionals locally who have responsibility for service, delivery and patient treatment, and the decision about which treatment to prescribe is made on the basis of an individual clinical decision by the prescriber, taking into account the patient's condition and medical history. I wonder if my colleague is also referring to the issue around shortages in HRT, which is a UK-wide issue. The supply of medicines in any associated shortages, as I am sure she is absolutely aware, is reserved to the UK Government. We will continue to work with them to seek a lasting resolution and to press them to work closely with the affected companies to address that particular problem as quickly as possible. Before moving on to question 2, I would like to make a plea for more succinct questions and answers. Question 2, David Torrance. To ask the Scottish Government what support it is giving to primary care services as a recover from the Covid-19 pandemic. Cabinet Secretary, Humza Yousaf. We are committed to increasing investment in primary care services as they recover from the pandemic priorities. Of course, they include the delivery of the extended general practice multidisciplinary teams to ensure that patients are seen by the right person at the right time. Funding for that has increased from £155 million to £170 million this year with 3,222 members of multidisciplinary teams already in post. We are also supporting recovery of NHS dentistry by investing £20 million to allow dentists to see more patients with a particular focus on children and tackling oral health inequalities. Staff recovery and wellbeing is also critical to renewing our NHS and support includes the national wellbeing hub and confidential staff helpline. David Torrance. I thank the cabinet secretary for that answer. Kingham Surgery in my constituency has been without full-time GPs for several months now. Can I ask the cabinet secretary what assistance the Scottish Government can give to resolve the issue and provide reassurance for my constituents? I am happy to reach into local health, board and social care partnership. As I have already referenced, we are putting significant amounts of investment into general practice. In particular, to general practice recruitment, we have a target to increase the number of GPs by 800 by 2027. We are making good progress with 277 GPs already recruited. Our GP training recruitment fill rate this year was 100 per cent. Again, an improvement on last year and very successful indeed. I will reach into local stakeholders in relation to the issue that David Torrance references and I will write to him with an update. The lack of specialist clinics, the waiting times for surgery, delayed discharge and the stagnation of patient flow through hospitals has led to desperate patients turning to GPs and we are overwhelmed and patients are angry. Support from pharmacies is vital through independent prescribing to reduce GP workload. What data does the Government collect and have that tells us how many prescriptions are done per pharmacy per day to ensure that this Government funding is effective because the Pharmacist Defence Association does not believe it is? I have received correspondence in relation to some of those concerns that have been raised and written back to a number of members of the Scottish Parliament. I would say that pharmacists play an incredibly important role to help to alleviate those pressures right across the system, whether they are in acute sites, whether they are in community pharmacies, whether they are in GP practices and some of the money that I have just referenced in terms of the MDT staff members that have been recruited, pharmacists and pharmacy technicians have made up a significant proportion of those additional MDT staff recruited. For example, if I looked at the number of pharmacy technicians, we had 38.3 energy practices in 2018 and now have 2022. On the specific question around the prescriptions, I will look into that and I will write back to the member with further detail. I want to place on record my thanks to our pharmacists up and down the country, whichever setting they are in, for the incredible work that they do to help to alleviate the pressure on our NHS and social care. I am very glad that the cabinet secretary recognised the importance of pharmacists. It is very worrying to see the growth in closures of pharmacies and the impact that this has on carers and patients. The Pharmacist Defence Association has highlighted how the owners of those pharmacies are all able to claim non-activity-based payments after closure, enabling some of them to enhance their profitability at the expense of patient safety. Will the minister outline what range of actions health boards can take to deal with those closures, given that the present arrangements have failed to stop them, and does he intend to add additional actions to discourage further closures? If my memory serves me correct, and I will correct it if I am wrong, I may have written to Jackie Baillie on this very issue, because she has written to me with those concerns that both she and Dr Sandish Gohani have just raised. Of course, I reference the fact that the closures are very few, but that is not to say that they do not have an impact. Even if they are few, they may well have an impact. It is, of course, for those local health boards to look at the contracts that they have, and, of course, if anybody is in breach of those contracts in terms of pharmacy provision, then action can be taken. In addition to that, a number of asks that have come forward from members in my response back to Jackie Baillie, I have said that I will look at those, and, of course, update Parliament in due course. 3. Mercedys Bielber To ask the Scottish Government what its response is to the findings of the 2021-22 health and care experience survey in relation to patient satisfaction with GP services. Cabinet Secretary. I think that we would say that, of course, any reduction in that experience is regrettable, but I hope that the context of that particular survey is well understood, and I am certainly understood by Ms Bielber, but I am also understood by members right across the chamber, and that context, of course, was the pandemic. Guidance is issued to GP practices not to treat patients face-to-face unless clinically necessary. Social distancing is introduced into practices, and while there were more remote consultations, electronic booking systems were used less as existing systems could not screen for Covid-19 symptoms. What we will do is continue to invest in GP practices. We want people to have access to those services to similar levels as they did pre-pandemic. Of course, the health and care experience survey is a vital tool for us to get that direct feedback from patients across the country. 3. Mercedys Bielber The health and care experience survey results show that patients are dissatisfied with GP services at medical practices that were put out to tender in Aberdeen earlier this year. I have previously shared the testimonies of patients at Old Aberdeen medical practice with the cabinet secretary. In a letter to me today, the cabinet secretary stated that his officials have communicated his expectation that GP practice monitoring should resume in Aberdeen as soon as is practically possible. What about reported declining standards that are already reported to have happened in recent months? Will the cabinet secretary request that NHS Grampian sets out a plan to address the issues that have already been identified by patients such as those at Old Aberdeen? The cabinet secretary raised a fair point. Some of the scores in the health and care experience survey for the new burn practice, for example, were far beyond acceptable. They were not acceptable. Some of those scores were far below the Scottish average. Somewhere above the Scottish average, we have to recognise too, but some of the scores, particularly in relation to accessibility and the ability to get an appointment within three working days, were particularly low. I will ask my officials to reach in to local partners to determine the improvement plan that those practices will be putting in place to give a reassurance about the actions that they will be taking to see an improvement in that patient experience. Does the cabinet secretary agree that much patient frustration lies with the offener cake appointment systems employed by some GP practices? I have had constituents ill people call 100 to 150 times to get through, if at all, some practices. What steps can the Scottish Government take to ensure that systems whereby folk know where they are on the telephone queue are implemented as standard? A very good point raised by Kenny Gibson. There is no doubt at all that a lot of the frustration, understandable frustration from members of the public is when they have to phone up a GP practice and it is a game of Russian roulette and whether or not they get through. That is, I would hope, the minority and I do not doubt the minority of cases. I take what he says on board and I just had a discussion in fact this morning about the fact that every single GP practice should have that pre-bookable appointment in place. I accept what Kenny Gibson says and I am happy to keep him and other members up to date as we progress that matter. Freikam Health Centre in Angus scored 95.46 positive score in the health and care experience survey. It was the highest score across Tayside, but difficulties recruiting GPs to the surgery meant that it closed earlier this year, moving 3,000 patients elsewhere. That was another huge blow for rural patient care. The Scottish Government committed to a £20,000 golden hello to help fill rural vacancies. Why, cabinet secretary, is this simply not working? A particular issue with that particular practice that was raised with me by the local constituency MSP at the time and rightly, of course, those matters are taken forward at a local level. The member is right that we have a number of incentives in place to make GP practices in rural and remote areas more attractive. The golden hello scheme, the GPST bursary and the SCOTGEM programme, which has just seen its first cohort, are graduating. I am hoping that all those issues, plus the work that we are doing on the back of Sir Lewis Ritchie's report, will begin to see more and more people, more and more of our doctors, more and more of our GPs, take up those roles in remote rural and island communities. To ask the Scottish Government what its response is to the latest alcohol-related death statistics. Nobody should die as a result of alcohol consumption and my thoughts go out to all affected. We are working with various organisations across Scotland, including ADPs, to address that issue. That includes piloting an innovative, managed alcohol programme and partnership with the Simon community Scotland, commissioning Public Health Scotland to review alcohol brief interventions, consulting on a range of potential alcohol marketing restrictions in Scotland, and fully evaluating minimum unit pricing. We support the principles of the right to recovery, and those will be embedded in the national care service, enabling everyone to access the treatment that they need. Jamie Greene Can I thank the minister for that response? I share her comments. Every loss of life is tragic, be it to drugs or alcohol. They are really Scotland's second national shame alongside our drugs crisis. The reality is that Audit Scotland is very clear about the scale of the cuts that were made as far back as 2014 to frontline alcohol services. That is why in my region, alcohol-related deaths are up 10 per cent in the past four years. That is why, right across Scotland, you are 5.6 times more likely to die of alcohol-related disease if you live in a deprived area. Can I make a plea to the minister and the entire front bench of the Government? Please listen to those on the front line who are desperately in need of support. They need help, and it is simply not there for far too many. Will this Government double down—and I really mean double down on its efforts—to tackle alcohol-related problems in society, properly fund them, properly resource them, given their notable lack of absence in yesterday's programme for government? I absolutely agree that alcohol and drug-related harms are vitally important public health issues in Scotland. That is why we established a national mission to improve and to save lives. At the core of that is ensuring that every individual is able to access the treatment and recovery that they choose. Alcohol is a priority for the Scottish Government. Our alcohol and drugs teams work closely with each other. They share knowledge around what works and are ways to reduce the impact of addiction, as well as routes through to treatment. Alcohol-related and specific deaths, as the member says, are disproportionately higher in deprived communities. That is why we continue to take a whole population approach when it comes to reducing alcohol consumption and the risk of alcohol-related harms. That, in turn, will drive reductions in alcohol harm in our most deprived communities. We are also, as the Government, taking action to improve the conditions that drive alcohol harms—reducing poverty and inequalities, providing good-quality affordable housing, and enabling the best start in life for our children. I have to say at many times that it feels like we are working with one hand behind our back in terms of how we give with one hand and the UK Government takes with the other. In light of the tragic public health emergency, can the minister advise whether the Government intends to introduce an alcohol harm prevention levy on alcohol retailers to help to fund alcohol prevention activity and the much-needed support services? As I said before, I am willing to consider all suggestions in how we tackle alcohol-related harm. The workstreams that we have at the moment are many and extensive and I would expect to deliver results. I am looking forward to seeing the evaluation on minimum unit pricing, which I think will be the most extensively studied policy that we have ever passed in this Parliament at the time that we come to review as a Parliament whether it should be continued. At the same time as that, we will also be looking at whether we have an appropriate minimum unit price. Of course, that was introduced more than a decade before, and I think that it is timely that we review that. We are also looking, as I said, at alcohol brief interventions—those conversations that might open up and help people to consider and understand that they have an alcohol problem, where they can be used most appropriately and how we can maximise the impact from that. Of course, alcohol advertising, we still, as the figures show, have a profoundly unhealthy relationship with alcohol in Scotland, and we need to shift that culture. I think that tackling alcohol advertising will absolutely be part of that. To ask the Scottish Government whether it will provide an update on the proposed national treatment centres for NHS Tayside and NHS Fife. Cabinet secretary. At the NHS Fife national treatment centres, a £33 million project will see the creation of a state-of-the-art facility hosting three operating theatres supporting inpatient ward and associated outpatient facilities. Construction at the site began in March 2021. It is well under way, assuming that there is no unavoidable delays. The project is in course to complete construction in October of this year. The first patient is treated in January next year. The business case for NHS Tayside national treatment centre is under development following a project pause in March 2020 during the pandemic. The proposals are being refreshed to meet current and future demand and to ensure that they meet our net zero carbon ambitions as well. An update on the opening date will be provided in due course. I welcome the cabinet secretary's response to that question. We are still in a situation where 1 in 9 Scots are waiting more than a year to receive essential treatment, so they need hope right now that things are going to change. Can the cabinet secretary clarify what the focus of the treatment centres in NHS Tayside and NHS Fife will be and what an estimated impact it will have on tackling the backlog of elective surgeries and procedures? Any comments he can make about how staff capacity can effectively support the delivery of specialist services as the centres become operational? All those points are well made by Mark Ruskell. I cannot emphasise or overstate just how important and critical the national treatment centres are in order to help us with the backlog. You will know that the NTC programme has announced pre-pandemic. It was important to get through what was a challenging position, which has been exacerbated by the effects of the pandemic. They are critical, they are absolutely vital. They will of course be national treatment centres, so while those who are local to Fife, to Tayside, will of course benefit, they will of course be the ability to help and provide that mutual aid to other parts of the country. I would say that the national treatment centres are important for the localities that are in, but also important for us nationally. Staffing for the Fife centre in particular is very much well under way. There are no signalled issues or concerns around staffing the NTC, but I am sure that he will appreciate that that will be done over a phased manner as the NTC opens and becomes fully operational. Thank you. Before we call on question number six, again I would make a plea for succinct questions and ministers' presence succinct answers. Question number six, Stuart McMillan. To ask the Scottish Government what discussions it has had with the British Medical Association regarding the impact in Scotland of its guidance advising GPs to consider reducing their pensionable pay while retiring early due to changes in inflation and the way that those are used in calculations around GP pensions that reportedly leave some libel for significant tax changes. The member and other members will be aware that the majority of the pension issues raised are reserved for the UK Government, and I, of course, have not had the opportunity to meet with the new UK Government in health counterpart, but I have raised those issues before and there has not been any flexibility on their position in this particular matter. The Scottish Government and I have regular engagement, of course, with the British Medical Association and the issue of pensions arrangements that affect GPs and NHS employees directly and via the NHS pension scheme have been raised with me. I have an introductory meeting with the new chair of the BMA later this month, where I am certain that the issue is raised by the member, but I will once again be on the agenda. Stuart McMillan. Thank you, thank you, cabinet secretary, for that reply. In addition to other MSPs from across the chamber, I recently met with the leadership of the local medical committee who are upset that GPs and their practices within the NHS go to the Glasgow and Clyde area. During that meeting, they highlighted the long-standing issue of pensions and how they are leading some GPs considering leaving the profession early or reducing their working hours to avoid what the BMA has claimed that amounts to, and I quote, a pension theft. As our NHS continues to contend with the impact of the pandemic, the cabinet secretary agreed with me that it is vital that the UK Government considers that changes to the tax-free annual allowance charges so that more GPs are not faced with this dilemma, which will only exacerbate the staffing issues facing general practice. I agree wholeheartedly, and as I have said before, I have raised this issue with UK counterparts. There has been no flexibility in their position. There are actions that we may well be able to take, but it is again taking money from other areas within the health budget to try to mitigate a problem that the UK Government is showing in flexibility on. I will look forward to the first meeting with the new secretary of state for health, I am sure, in very short order. I will raise the issues with her again, and I am sure that the DFM John Swinney in his position will continue to convey to the chief secretary of the treasury our displeasure at these pension changes that have caused such difficulty for GPs and doctors right across the country. The health secretary does have the power to sort this. He could use recycling of pension contributions, which the BMA has put to him. It is available in Wales, in many parts of England, and Northern Ireland are looking at it. Why is he refusing to go down this route? It could release doctors back into the NHS to deploy them where they are needed. Why is he not doing it? I am not refusing it, it is actively under consideration, but I go back to the point that dealing with the pension issue route cause, as opposed to having to take money out of other parts of the health budget and the Scottish health budget, would be preferable. I am pushing forward and pushing the UK Government to make changes to pensions where they can, and that would help to alleviate some of that pressure. I am very open to looking at a rec scheme, and I know that a rec scheme has been available, and that is why I will be meeting Dr Kennedy, the chair of the BMA, later on this month. I will provide an update to members in due course. Question 7, Liam McArthur. The Scottish Government, when it last met NHS Orkney and what issues were discussed. I met with the board's chief executive and other senior staff when I visited NHS Orkney on 16 and 17 August. Thank you. I have been contacted this week by a local GP in Orkney confirming that rising heating costs will cause significant implications for the health of his patients. He explains that, quote, stress caused by financial hardship will adversely affect mental health, and folk turning heating down or off will have negative physical impacts on health. This will create more ill health and further increase NHS workload. So, while we clearly need urgent action from the new Prime Minister to address the cost of energy crisis, can the health secretary advise what additional support has been made available to NHS Orkney and other health boards to help deal with the increased workload and health impacts referred to by my constituent? Liam McArthur is, of course, right. The cost of living crisis is a public health crisis if people have to choose between heating and eating. Either choice that they make is going to have a detrimental impact on their public health. He is also right to make the point that our hospitals, our primary care services, our social care services will feel the pinch because of the rising costs of inflation and indeed of energy bills. As the First Minister outlined yesterday in the programme for government, there is support that we are providing to the public, particularly those that will be hit the hardest. I will not rehearse them due to the reasons of brevity, but what I would say is that the meaningful action on this remains in the hands of the UK Government and therefore we urge the new Prime Minister, the new chancellor, to come forward with meaningful measures that will make a significant difference in the face of these rising energy prices because only they have the powers to freeze or to cap those energy price rises. I will now continue my engagement with NHS Orkney and other health boards in this regard. I can squeeze in question number eight if I have succinct questions and answers. Question number eight, Gillian Martin. I am very grateful, Presiding Officer, to ask the Scottish Government how it is assisting GP practices in Aberdeenshire to fill vacant GP and health practitioner posts. Cabinet Secretary, we offer a wide range of initiatives specifically to attract GPs to rural areas such as Aberdeenshire. It includes the golden hellos and bursaries for newly qualified GPs to take up posts and hard to fill rural locations. I would add that our new ScotGem graduate entry medicine programme, focusing on general practice and rural working, is proving popular. The first cohort of 44 students graduating earlier this year from Dundee and St Andrews universities. Gillian Martin. I thank the cabinet secretary for that answer. The situation in my constituency is becoming critical with five-year-old mild on practice down to two part-time GPs and getting no applications for repeated GP post-advertisements over the last couple of years, mental or practice. It is sad to be taken back under control of NHS Grampen with central working behind it. Cabinet secretary, I have already mentioned incentives in his response to me, but is the Government considering developing any new inventive schemes that can further incentivise those who have left general practice to return and incentivise new graduates to base themselves in rural areas like mine? I will ask my officials to reach in again to colleagues in Aberdeenshire in terms of local health and social care partnership and local health board and grampian around the specific issues that Ms Martin raises. We have a range of initiatives. Of course, the ScotGem programme is still in its early, early days, but I have no doubt at all that ScotGem programme will make a big and significant difference to the vacancies that exist in GP practices in remote, rural and island communities. On the specifics, I will ask my officials to reach in to local partners and provide an update to Ms Martin in due course. Cabinet secretary, that concludes portfolio questions on health and social care, and we will now move on to portfolio questions on social justice, housing and local government. Allow a very short pause in order for front-bench teams to change position. We are now moving on to portfolio questions on social justice, housing and local government. If a member wishes to request a supplementary question, they should press the request of speak button or enter the letter R in the chat function during the relevant question. I would like to ask the Scottish Government whether it will confirm when actions to remove cladding from properties identified as dangerous under the single building assessment programme will be completed. We are taking priority action to address cladding safety issues having expanded our single building assessment programme, which determines the safety risk from cladding systems on domestic blocks of flats from 26 to around 100 buildings. We expect the vast majority of buildings assessed to be found to be safe and continue to prioritise higher risk buildings. If cladding is assessed to be high risk, homeowners will be invited to discuss the assessment and agree actions required to make their buildings safe. We are working on agreeing the Scottish Safer Buildings Accord with the expectation that developers take responsibility for remediating their buildings. I thank the cabinet secretary for that answer. My constituents in Glasgow, Kelvin, can be reassured that those projects continued at pace. When announcing the Scottish Safer Buildings Accord in May, the cabinet secretary underlined that a joint and collaborative approach was key to resolving the issue of unsafe cladding. Can she provide an update on how the Accord has been received by partners across the sector? Yes, I can. We are working closely with our partners as we bring together all the stages of the Accord design. Our collaborative approach through engagement and information sharing will create this unique and complex agreement. Homes for Scotland, as our key partner and representative body of the developer sector, strengthens this approach. It is important to bring sectoral understanding and responsibilities to unlocking and resolving the issue of unsafe cladding for homeowners in multi-residential buildings across Scotland. I will keep Parliament informed when the Accord is finalised. A series of freedom of information requests have indicated that 88 school buildings in Scotland still have flammable cladding of the same or similar type to Grenfell Tower. Does the cabinet secretary believe that it is acceptable to be putting those lives at risk by delaying the removal of this dangerous cladding, and when will it be removed from all school buildings in Scotland? As I am sure Jeremy Balfour will understand, it is the statutory responsibility of local authorities to manage and maintain their school estate. We expect local authorities to deliver a safe environment for all school users. The responses that were gathered from local authorities showed that, at the time, post Grenfell, there was not a large-scale problem across the school's estate in Scotland. Of course, the Deputy First Minister wrote to local authorities to request assurance that the school estate was considered safe in terms of fire safety, and assurances were provided by all 32 local authorities. Jeremy Balfour will also understand that the focus of the Government, as is the case in England and Wales, has been on those residential blocks where people are living, where there is unsafe cladding, because those are the buildings that are most at risk. That is the expert opinion, and that is why we focus our attention on tackling those residential buildings and the funding to make sure that we play our part in resolving those cladding issues as soon as possible. There are hundreds of buildings in Scotland with highly combustible high-pressure laminate on them. Schools are some, colleges, unis, private schools, hospitals, prisons, hotels and care homes, as well as houses. Minutes of the building and safety working group said that, following the pilot of 26 building assessments, a further 100 will be done in the course of a year. In May this year, only one single high-rise building in Glasgow is known to have been assessed. Given the scale of the problem across Scotland, does the Scottish Government recognise that much more action is urgently required to address the scale of the problem, and can the cabinet secretary advise how many buildings in Glasgow are believed to be affected, particularly given that the Scottish Government's office in Glasgow at Atlantic Key was recently revealed as one such building? As I said to Jeremy Balfour, Pam Duncan Glancy is also conflating two different issues here. One is about residential buildings where there are people living in those buildings, and that has been the focus of our attention, as is the case with the Welsh Government and the UK Government, in order to focus on those buildings most at risk. That is what we are all doing, and that is the right thing to do. Of course, we have committed £400 million in order to take that forward. The accord will help with that, because it will mean that those buildings that can be assigned to a developer will remediate that building and resource the means that our resources will be able to focus on those buildings that have no developer associated with it. That is where we are focusing our attention on those 100 buildings. The other buildings that Pam Duncan Glancy referred to are public buildings. We would expect whether it is a hospital or a school for those organisations, whether it is a health board or a local authority, to take the lead in making sure that their buildings are safe. She will be aware of the issues that are being looked at at the Queen Elizabeth hospital at the moment. That is the right and proper way to go about those things. They are complex issues, but the approach that I have laid out to Pam Duncan Glancy is the right approach. 2. Not lodged 3. Not lodged 4. Christine Grahame Thank you very much, Presiding Officer. To ask the Scottish Government what impact inflation, energy prices and interest rates are having on housing costs in Midlothian South, Tweeddale and Lauderdale. The impacts of the costabilling crisis are being felt by all households in Scotland, including in Christine Grahame's constituency, and are disproportionately impacting people on the lowest incomes, including renters and those without fixed-rate mortgages. The key levers for tackling the crisis remain in the hands of the UK Government, and, of course, they must act now. However, our programme for government set out yesterday the steps that we are taking within our limited powers that we are investing in additional £5 million in discretionary housing payments and extending the scope of the tenant grant fund. We are also introducing rent controls to strengthen tenants' rights and a temporary moratorium on evictions. Christine Grahame I thank the cabinet secretary for her answer. I also welcome anouncement in the statement yesterday of emergency legislation to fees rents across private and socially rented sector, but I ask for the many constituents that I have in Midlothian South, Tweeddale and Lauderdale who are concerned about mortgage payments as interest rates rise. What interventions, if any, given that a lot of this is reserved, are open to the Scottish Government to assist them? First of all, I welcome Christine Grahame's identification of the emergency legislation as a significant intervention, but she raises an important point about those on mortgages that are struggling. There is a support fund available—I am happy to write to Christine Grahame—that provides the ability for people who are struggling. Those are people who are on low incomes, so it is not all mortgage holders, but those who are on low incomes who are able to access that fund that can convert a mortgage to rent or a mortgage to shared equity. We are looking and reviewing that at the moment to see whether we can make that fund more available to support people, but lenders and advice agencies are aware of it, but I am happy to write to Christine Grahame with that information. Colin Smyth Thank you, Presiding Officer. House prices are rising at a faster rate in rural areas—13.5 per cent in the borders alone last year. As more people seek a rural lifestyle post pandemic, South of Scotland Enterprise has identified that lack of affordable housing is the biggest barrier to attracting the workforce that we need in the area. Does the cabinet secretary accept that the Government needs to review the target that equates to just 10 per cent of new affordable homes being built in rural communities, or that demand will continue to outstrip supply, driving up housing costs and prices further? I can say to the member that we have been focusing very much on the needs of housing in rural and remote Scotland. That is why we are bringing forward a plan that will address the needs within rural and remote Scotland. We are looking at some of the barriers and the timelines that it takes to get housing development off the ground. We are looking at how we can remove some of those barriers. We are making a significant investment in the affordable housing supply programme, £3.6 billion over the course of this Parliament to deliver 110 affordable homes by 2032, many of which will be in the member's area. We will continue to do that, but we are always looking at ways in which we can make that money go further. We are working with local partners to make sure that we deliver as many affordable homes across all of Scotland. What further support will it provide to local authorities for the provision of accommodation for refugees in Scotland, in light of reports that suitable housing has been significantly reduced as a result of the super-sponsor scheme? The first point to make is that immigration asylum systems are fully reserved to the UK Government. Although local authorities continue to support resettlement schemes by offering accommodation and support in their areas, it is the home office that is responsible for the design and operation of resettlement schemes and the UK asylum system. Refugees who have been granted status following an asylum application have the same rights to access housing as anyone legally resident in Scotland. Since the Ukraine War, under our super-sponsor scheme, to ensure that displaced people could travel here safely and immediately, the Scottish Government has provided direct provision of accommodation and support, and we have also made £11.2 million available to local authorities to support this work. It is clear that houses are not there. Aberdeen City Council last administration launched the city's largest council house building programme in decades. Last month, the new SNP Lib Dem administration froze four big developments that would deliver over 500 new council homes in the city, with the SNP leader citing budget pressures. Will the SNP Green devolved Government get their act together, give Aberdeen a fair share of funding and allow Aberdeen to build the new council homes that can be used to welcome people to the Granite City? I do not think that the Tories are on strong ground talking about council houses at all, given the sell-off of tens of thousands of them under their watch over the past few years. Let's look at the situation in Aberdeen. I have provided all local authorities with the assurance over five years around the affordable housing supply programme investment. We expect all local authorities to come forward with their local housing plans in order to meet local need, but he linked the question with the issue of Ukraine. I can tell him that Aberdeen City Council has been working extremely hard to come forward with proposals in order to help with the settlement of Ukrainian refugees. If perhaps he had better communication with his local authority, he would know about some of those very important plans. I suggest that he gets in touch and brings himself up to speed. Does the cabinet secretary agree with me that it is somewhat ironic that, while the Scottish Government is doing everything that it can to support refugees taking 18 per cent of the Ukrainian refugees in the UK? The UK Tory Government is hellbent in flying other asylum seekers out to the Rwanda to deter them from settling here. The irony never ceases to amaze me, Deputy Presiding Officer, and Stuart McMillan makes a very important point. Of course, we are doing what we can with the new Scots refugee integration strategy, trying to support people to settle and integrate. Of course, on the Ukraine programme, we, as the First Minister, set out yesterday and the Deputy First Minister set out, almost 16,000 people have arrived with a Scottish sponsor here in Scotland, representing 18 per cent of all UK arrivals, the most per head of any of the four nations, if only perhaps other countries could step up to the mark as well. To ask the Scottish Government what analysis it has done on the potential impact on the sale price of new homes of its proposal to introduce new building standards to prohibit the use of direct emissions heating systems in new builds from 2024. I would like to begin by referring the member to the answer to question SXW-10120, which was provided on 25 August this year. Research cited, found that the installation of zero emissions heating systems has ranged from £2,000 to £5,000 more than gas boilers. Although those costs are highly variable, they depend on a range of factors, and, importantly, they do not represent predictions for the costs after the 2024 change. The sale price of a new building is, of course, determined by individual developers and takes account of a wide range of variables related to building construction costs and local housing markets. Heating system installation costs typically have a smaller impact on prices than other factors. I would also like to refer to that parliamentary question, which did not answer my question, rather than his answer. The minister admitted to me in that that installing zero direct emissions heating systems from 2024 will cost up to £5,000 more per home. In 2019-20, the last year before the pandemic intervened, the private sector built more than 16,000 new homes, so, if Mr Harvey's rule had been in place, up to £82 million would be added to construction costs. I wonder what impact adding £82 million to construction costs will have on families and first-time buyers' ability to afford a new home. I am sorry that Mr Kerr did not choose to listen to the answer that I gave, which explicitly said that I was not making a prediction about what the cost of zero emission heating systems would be after 2024. He suggested that I have made that prediction and I have not. Everybody within the industry is clear that we need to scale up not only the production of this kit and many of the jobs—really valuable jobs—doing that work will be located here in Scotland, but also the capacity of the industry to carry out those installations. We are working with the industry to build that capacity and that is expected to reduce the costs over time. Very clearly, all political parties have committed to the legally binding climate targets, which cannot be met without ambitious action on zero emission heating. I wish for goodness' sake that the Conservative Party would start getting behind the actions that the Scottish Government is taking, which will make sure that we not only hit those climate targets but do it in a way that benefits the cost of living and the economy in Scotland. I would hope to be able to call questions 7 and 8, but I would need to have succinct questions and answers. Question 7, Alex Rowley. How many houses it estimates needs to be built to tackle the current housing weight in less than Scotland? Cabinet Secretary. We are committed to delivering 110,000 affordable homes by 2032, of which at least 70 per cent will be available for social rent and 10 per cent will be in remote rural and island communities, and we will invest £3.6 billion in that parliamentary term towards the delivery of more affordable homes across Scotland, with £30 million of that investment supporting the continuation of the rural and island housing fund. Alex Rowley. Children trapped in temporary accommodation in Scotland is at its highest levels on record, up 17 per cent in one year. Families in central belt of Scotland are being offered housing in the north of England because of a lack of housing in Scotland, and according to Shelter, 130,000 households are on waiting lists for social homes. Shelter has written to the First Minister and is calling for an emergency action plan that will buy and build 38,500 social homes by 2026. Will the Government make housing a national priority and will the Government bring forward a costed national emergency plan so that we can address this unacceptable blight on our country? It makes economic sense and it is the right thing to do. Cabinet Secretary? Well, affordable homes and affordable housing is a national priority, which is why £3.6 billion will be allocated—is allocated—during this parliamentary term. That is a very, very clear commitment on our part to build more affordable homes. Alex Rowley talks about a very important issue of temporary accommodation, and he mentions Shelter. Of course, I have asked Shelter, who has accepted to lead an expert group and head up an expert group to look at what further solutions we can bring to tackle temporary accommodation, because he is absolutely right that there are too many families, particularly families of children, in temporary accommodation. Therefore, it is one of my key priorities to target, and Shelter will help us in doing that work. I should point out that there are 20 local authorities out of the 32 that have managed to reduce the number of people in temporary accommodation since last year. However, there is more work to be done in reducing the numbers in temporary accommodation, and that is exactly what we are determined to do. I will now have to move directly to question 8, because we are running out of time, and I would ask for brief questions and answers. To ask the Scottish Government what its response is to the increase in the number of children in temporary accommodation, as reported in the annual homelessness in Scotland statistics. As I have just said, I am very concerned by the increase. I am aware that the impacts of the pandemic are still being felt by local authorities, and they are also facing challenges in meeting some households' needs. That has reflected very much in the backlog of households waiting for settled homes, but the figures are unacceptable. As I said in the previous answer, I have discussed solutions to temporary accommodation pressures with housing conveners. I have also asked an expert group, chaired by Shelter Scotland and the Association of Local Authority Chief Housing Officers, for an action plan, and I am expecting the initial recommendations to be delivered by the end of the year. Ruth Maguire. I thank the cabinet secretary for that answer. Empty properties left in disrepair are a blight on neighbourhoods and could be providing much-needed homes to family and children on waiting lists. Can the cabinet secretary provide an update on the progress of compulsory sale orders, and will the Scottish Government consider the proposal for compulsory rental orders? Ruth Maguire makes an important point, and we are committed to modernising the compulsory purchase order process to make it clearer, fairer and faster for all parties and to support the delivery of projects that are in the public interest. Compulsory sales orders are being considered as part of that. Any new powers, of course, would need to be compliant with the European Convention on Human Rights, and compatibility with existing powers need to be carefully considered. That includes any proposals for compulsory rental orders, but I am happy to keep the member updated of progress. That concludes portfolio questions, and there will be a very short pause before we move on to the next item of business.