 am y dyfodol i gweithio ei gweithio a'r ddif Weinidog yn ddigwyddio arallwch allu llaweru nesaf i gael ei gweithio ar lle ei gweithio, yr oedd y gwneud yr argyn iawn i chi'n ei ddifetio ar y llain sydd hefyd yn y ddifesig. Dylech chi'n mynd i ddifesig? Derydd ddifu mor panllwanol i gweithi'r rhag等ig, ond y prif showing y ddifesig fel hynny, a hynny nesaf i fydd yn ei wneud y ddod. Mae'r ddifesig yn ei gweithio arlawn i gyfer lle oherwydd i gweithio a'i ddylau I am aware of the important issue that the member raises and obviously it is vital that members have the information that they need and in a timely fashion and hence we will now look into the matter that the member has flagged up to the chamber with a view to ascertaining what is happening. The first item of business this afternoon is portfolio questions and the first portfolio is rural affairs, land reform and islands and as always I would make a plea for succinct questions and answers in order that I can call as many members seeking to participate as possible. I call question number one, Bill Kidd. Thank you very much, Presiding Officer, to ask the Scottish Government what discussions have taken place with Forestry and Land Scotland regarding the upcoming 2023 UCI Cycling World Championships? First of all I would just like to say that we are all delighted that Scotland is hosting this groundbreaking sporting event this summer. For one country to host all of the UCI Cycling World Championships is unique and Cycling World Championships Limited are working with Forestry and Land Scotland on preparations to host various competitions and disciplines. The Scottish Government sits alongside Forestry and Land Scotland on the group such as the Cycling World Championships Policy Advisory Group and the Cycling World Championships Marketing and Communications Group to help to progress those preparations. Bill Kidd. Thank you very much for that reply. Whilst Glasgow will be the host city and undoubtedly rise to the occasion of giving the competitors and spectators a warm welcome, all of Scotland will play its part in marking this occasion with key events like mountain biking being held at Glintress and Fort William as well as in Glasgow. Can I ask the Cabinet Secretary what role our national forests are playing in supporting this historic and unique event? I think the member for that question because I think it's important to highlight that Glasgow of course given its track record and the facilities that it has will be at the heart of activity but it's our national forests that are going to provide that really spectacular backdrop that we have for those key disciplines including the world mountain bike cross country at the Glintress centre and mountain bike downhill at Fort William. A key aim of the 2023 UCI World Championships is for the event to demonstrate our nation's natural beauty as well as that warm welcome. We can really look forward to seeing Perthshire, Dumfries and Galloway, Fife and Stirling all feature with a showcase of all that Scotland has to offer to a really unrivaled world audience. Many events such as the road races and time trials of course are going to be free to view which I hope really will help introduce cycling and cycling events to wider audience as well as then encourage people from all over the country to go along and view what will be really spectacular events. To ask the Scottish Government what steps it is taking to boost the Scottish salmon industry. The Scottish Government remains absolutely committed to the sustainable development of our world leading aquaculture industry, not least because of the significant economic value the sector brings for more remote areas. The wider supply chain and all the jobs that the sector supports. We are working to support business by streamlining the consenting process for fish farms to make that more effective transparent as well as making it more efficient. We are also supporting the sustainable aquaculture innovation centre and we are collaborating with producers and others to support fish health and welfare in Scotland. I thank the cabinet secretary for that response. It's well known that Scotland's native wild salmon are in a perilous state with populations continuing to decline. Predation is a grief factor in that decline with predators such as cormorants and seals impacting on numbers. The effects are intensified but anthropogenic pressures including barriers and impoundments that alter habitats and disrupt migration. Through fisheries and wider tourism, the wild salmon industry is a key component of the rural economy, not least in Fife, where a number of key fisheries are located. A recent Scottish-wide economic assessment of the wild fisheries estimated that the industry is responsible for 4,300 jobs and contributes to just sort of 80 million in gross value added to the economy. So any review of fish eating bird policies? We need a question please. The member raises a really vital point and I'm glad that she's raised the iconic species for Scotland, the wild salmon, and has emphasised just how important that is. When the member talks about wild salmon being a key component of the rural economy I'm in absolute agreement with her. We recognise the importance of our wild salmon and we're also seriously concerned about the declines and numbers that we've seen. That's why we set out a wild salmon strategy and why we also published earlier this year a wild salmon implementation plan, which outlines all the key pressures and what action we're taking against that. So I'd be happy to furnish the member with that information so she can see what action we're taking against each of the pressures that salmon face, because we really do want to do all we can to really preserve and boost this iconic species for Scotland. Our salmon industry is a national asset providing a nutritious source of homegrown protein and employment opportunities in rural communities, with Europe reportedly continuing to be top destination for Scottish salmon. Does the cabinet secretary agree with me that the best way to enhance what our salmon industry has to offer Scotland and the world is to reverse Brexit and remove the bureaucracy and hardships that the Tories have forced on the sector? The member wouldn't be surprised that I absolutely do agree with her because her assessment is absolutely right. Brexit has been harmful to our entire seafood sector, including Scottish salmon. We did, as a Government, repeatedly warn about the UK Government that the forced exit from the European Union would be damaging to Scottish businesses and we still don't yet know the full implications of the trade and co-operation agreement for our aquaculture industry. I'd said here in the chamber last June that it's hugely disappointing that increased costs are threatening the competitiveness of Scotland's most valuable food export and I would really just repeat that remark a year on and I would continue to make clear that all of our food and drink sector would be better off with independence and with Scotland as a member of the EU. Last week, the Scottish salmon industry celebrated growth in exports to Asia. The salmon industry provides jobs to economically vulnerable island and coastal communities but the sector faces concerns about the impact of SNP green proposals for highly protected marine areas. Will the Scottish Government boost the salmon industry by going back to the drawing board on HPMA plans? I would really just emphasise that we never left the drawing board in relation to that. We consulted in relation to HPMAs at the earliest possible stage in the process. The member will now be aware that I visited Shetland a couple of weeks ago. We engaged with members of the aquaculture industry to hear their concerns directly. We are committed to that engagement and that ongoing engagement with communities as well as with impacted industries and sectors and we are continuing to listen to that. We are analysing the results of the consultation before we then set out next steps. To ask the Scottish Government what its response is to the letter from the Scottish Crayl Fishermen's Federation offering to assist with progressing fisheries management issues, including highly protected marine areas. We received a letter dated 22 May from the Scottish Crayl Fishermen's Federation offering assistance in progressing various matters, including ensure fisheries management initiatives. We are in the process of considering the points made and will respond in due course. Of course, the SCFF is involved in our co-management groups and I encourage them to continue supporting the fisheries management and conservation group and regional inshore fisheries group network. I thank the cabinet secretary for that answer. Scotland has a legal duty to manage our seas to good environmental status. That includes minimising seabed damage and maintaining fish stocks and wider biodiversity. Supporting low-impact fishers, like creelers and divers, will help us achieve this commitment while maintaining jobs in fishing. Does the cabinet secretary agree with me that creelers and scallop divers must be at the heart of fisheries management policies that will complement HPMAs? The member narrates, I think, very accurately much of what was put to us by the SCFF, which we are now considering very carefully. As part of delivering the UK marine strategy and ensuring good environmental status, we will shortly be publishing an updated programme of measures to include actions improving the status of our seabed. That will include working directly with the fishing industry and international partners to focus on identifying practical and achievable actions, reducing pressures on habitats, most at risk. I commit to working with all fishers and wider communities to ensuring that we have a healthy marine environment, including for commercial stocks, which are critical to maintaining jobs in the industry. Brendan Harra, the SNP's chief web at Westminster, has written to 11,000 householders in Argyll and Bute encouraging them to write to the First Minister over the ill-thought-out, ill-conceived HPMAs, joining thousands of stakeholders and MSPs across the chamber in condemning the policy. The process takes as fact that at least 10 per cent of our seas will be designated as HPMAs making a mockery of the consultation. The Scottish Government is clearly uninterested in discussing where HPMAs are imposed, not whether they are a case for making them. This is bad policy making. Will the consultation only ask the question of where there will be at least 10 per cent HPMAs, or whether there should be 10 per cent HPMAs? I can't quite believe that we are this far down the line, and it's obvious that Finlay Carson still hasn't actually read the consultation. It is an incredibly broad suite of questions, not just as he has characterised there, but a great deal more about what ought to constitute an HPMA. What might the site selection be, running through blue carbon, ecosystem recovery, leisure, fish stocks? Read the consultation for goodness sake before you come here and ask the Government's questions, which do not have any bearing in reality. Crelor's divers and indeed the whole fishing community want to protect our seas, because doing so is crucial to their survival, and yet their expertise appears ignored. Would the Cabinet Secretary agree that we need a joined up fisheries management, and that must be designed with and by the fishing community? How does she intend to re-engage Crelor's divers and the fishing community that has been alienated by the HPMA proposals? I absolutely agree with the first point that was made about the interconnectivity between healthy marine environment and support for those who rely economically on the seas. That goes to the heart of our blue economy vision and what we are hoping to achieve through our marine environment policies. I direct the member to the work that is due to be on going with the development of national marine plan 2. That will be a critical means by which we develop policies for our marine space, noting, of course, the increasing squeeze that is playing out there. As with the development of HPMAs, as with marine protected areas, as with priority marine features, we will be engaging very widely with all of those with an interest as we develop national marine plan 2. To ask the Scottish Government how many farmers and crofters it has supported this year through the single application form. The single application form is the application form that farmers and crofters must complete annually if they wish to claim a number of different support scheme payments. Last year, 19,408 businesses submitted a SAF, and to date, approximately £557 million of funding has been issued under the various direct payments and Scottish rural development plan support schemes with basic payment scheme and greening advanced payments issued into the rural economy at the earliest time ever. All scheme payments were started in line with the 2022 payment strategy timetable and have met or are on course to meet the payment performance targets. The 2023 SAF submission period opened on 15 March this year, and the penalty free submission period closed on 15 May, with 19,248 SAFs having been received to date. The late submission period runs until 9 June, with a 1 per cent per working day penalty applicable. The support that flows from completion of the single application form is vital to the wellbeing of Scotland's agricultural sector. In 2021, more than 93 per cent single application forms were submitted online through rural payments and services. I ask the cabinet secretary what percentage of applications the Government received online this year and what efficiencies are achieved by farmers using technology in this scenario. The member is absolutely right when she talks about the continuing importance of that funding coming through to the sector. I am pleased to say that more than 99 per cent of applications that we receive for the SAF were submitted online in 2023. We have only had seven paper applications submitted to date. That is a big step in the right direction because there are a number of benefits that come with submitting an online form. First of all, when it is submitted online, the information that is entered is validated, which, of course, reduces the risks of any errors and penalties. That application is pre-populated with the most up-to-date land information at the time an application is started. Farmers can also choose whether to add seasonal land used the year before. Applicants will then continue to receive email updates and notifications about the scheme acknowledgments and the payment letters, as well as a whole host of other benefits. As I have said in my response, I believe that that is a huge step in the right direction and that it is really positive to see that so many people are submitting their forms online. Thank you. I am hoping to be able to take the next three questions. I will need to think questions and also the cabinet secretary's succinct answers. I call question number five, Paul Sweeney. As a Scottish Government regarding its cross-government co-ordination on island connectivity, what discussions the rural affairs secretary has had with ministerial colleagues regarding any impact of the continued delay of vessels 801 and 802 on island communities? Minister Kevin Stewart. Thank you, Presiding Officer. I regret that those vessels are taking longer to deliver than estimated. I am working with the cabinet secretary for rural affairs, land reform and islands and other ministerial colleagues to understand the impact that this is having on island communities. That also requires dialogue with our local authority partners and that is why we have re-established the islands transport forum through the island strategic group. Furthermore, the First Minister's policy prospectus included a commitment to publish a new rural delivery plan that will cover the issues that are critical to Scotland's island communities, including transport. Paul Sweeney. Minister will be aware that the connectivity of Scotland's island communities has been severely hampered by the continued delay to these vessels, which are over £200 million over budget five years behind schedule. That does not include the economic impact to those island communities. Minister, what is the Government doing to ensure that Scotland's shipbuilding industry, which should be a national asset to our island communities as well as the whole country, is resilient and able to flourish in the future to supply a continuous shipbuilding programme for the ferries? Right now, it seems that the Government is content to simply capitulate on a national shipbuilding strategy and award future contracts for Seymal to Turkey. Surely he recognises that it is not sustainable and we must create a continuous shipbuilding programme in Scotland. The Scottish Government supports the growth of commercial shipbuilding in Scotland and has welcomed the UK Government's intention to introduce a shipbuilding credit guarantee scheme as part of the national shipbuilding strategy refresh. We look forward to the launch of that scheme and once the finer details of that scheme are known, we will work with the industry to establish how best to use the scheme and maximise its potential to support the growth of commercial shipbuilding in Scotland. The co-ordination and connectivity questions that the cabinet secretary mentioned, given the on-going pressures on the fleet, can he provide an update on progress with the delivery of the new vessels for the Little Munch and Isle services and on what benefits might be expected from their deployment? Thank you, Presiding Officer. Construction of the two new Isle vessels is well underway. On 25 May, steel cutting marked the official commencement of the construction of the first of the Little Munch vessels. Those vessels will bring benefits to island communities by improving the reliability, resilience and capacity of the ferry network. That includes the planned provision of a two vessel summer service on the Little Munch in place of the current single vessel service. I received a letter this morning from the transport minister rejecting the idea of a ferry compensation scheme for island communities affected by problems in the network, problems caused by the catastrophic handling of our ferry service by his Government over the years. In light of that and in light of the problems caused to island by the delays in the two vessels, will he reconsider that position? I have discussed that directly with a number of local businesses and communities. I did so last week with Alasdair Allan in North and South Uist and Benbecula. Although I understand the cause to support businesses through disruption, our focus rightly has to be on building resilience into the ferry network. That means that we are able to provide that resilience through the likes of the MV Alfred and investment of £9 million to build on that resilience. I think that many folks understand that we really need to invest in our ferry network to get this right for people as we move forward. That is why we have got 801, 802 and the four island class vessels being built at this moment. To ask the Scottish Government what actions it is taking to mitigate any negative effects of commercial forestry on farming. We have introduced positive initiatives to help farmers and crofters to get the benefits of growing trees and support their farming businesses. All woodland creation is assessed for its agricultural impact, and recent analysis shows that all types of woodland, including commercial forestry, have a vital role to play in reducing net co2 emissions. The Scottish Land Commission has found that there has been a notable increase in off-market or secret sales of farms to turn them into forestry. What is the Government doing to ensure that any secret sales are above board and are not sacrificing irreplaceable productive farmland to subsidise greenwashing through tree planting? Of course, I welcome the report that was put together by the Scottish Land Commission and I want to engage with it to discuss the outcomes of that directly. As I say, we undertake impact assessments. I was at the committee this morning where we talked about forestry and emphasised again that ultimately we want to see the right tree in the right place and we want to make sure that any transactions in that regard are handled appropriately and in the right way. I am more than happy to follow that up with the member and to discuss that further with him. I have been contacted by constituents in Dumfries and Galloway who have given examples of where forestry has been planted on prime agricultural land. Given the need to ensure food security in Scotland and our proud agricultural history, does the cabinet secretary agree that such examples are set out by following the right tree and the right place strategy? That is so important. Can she set out whether the Scottish Government is considering any action to stop large-scale commercial planting on prime agricultural land such as in Dumfries and Galloway? The member raises important points there. Just as I said in the previous response to a very much-believed and unsupportive of the right tree in the right place, because we want to ensure that food production and the actions to address the nature and climate crisis are addressed together. Through our work on the development of the Agriculture Bill, which is going to be introduced this year and the recent consultation on the future forestry grant scheme, we will be supporting that greater integration between farming and forestry through those incentives that we offer to land managers. To ask the Scottish Government what its position is on whether agricultural support is delivering value for money. First, I want to state that I remain committed to supporting active farming and food production. We are doing that with direct payments to provide that certainty and to support a just transition as we replace the common agricultural policy. I am committed to co-development and we all accept that to achieve our vision will require farmers and crofters to do more to deliver sustainable and regenerative farming and to maximise sustainable food production in ways that also actively benefit both nature and climate. That includes our commitment to shifting 50 per cent of direct payments to climate action and funding for on-farm nature restoration and enhancement by 2025. I thank the cabinet secretary for that reply. In new leadership a fresh start, the First Minister told us this. He said it is imperative that transparency underpins our approach to delivery. My Government will ensure that the people of Scotland have the information they need to hold us to account. At the moment when it comes to agricultural payments we can see where the money goes and we can see what the money was claimed for, but we cannot identify who receives that money. In the interest of transparency, to ensure that the people of Scotland have the information they need, will the cabinet secretary commit today to publish and update regularly a list of Scotland's landowners who receive Scottish Government agricultural support, including a league table by value in order broken down by gender of those who receive the most to those who receive the least? I want to thank the member for raising that important point. It also highlights some of the issues that we need to try to balance in relation to that. I know that we want to increase the transparency of who owns land in Scotland. That is why we have undertaken some measures so far. We also want to increase the diversity of land ownership in Scotland, which is where the proposals will bring forward in the land reform bill will be critically important in relation to that. I look forward to continuing those discussions as we bring forward our agriculture bill and our land reform bill to deliver on that transparency and accountability. It is a quality by buying local produced food to high environmental standards. Will the cabinet secretary be open to adopting Scottish Conservative plans to increase the amount of home grown food purchased by local authorities by introducing a 60-60 target or strategy, 60 per cent of local food sourced from farmers, fishermen and crofters from 60 miles within the region where possible? Those are commitments that we are already driving forward as a Government through our good food nation plan, our local food strategies, through the schemes that we are delivering with the soil association and the food for life scheme, where we want to deliver on exactly that. If the member wants to have a discussion with me about those measures that we are undertaking or areas that we could look to develop further, I am more than happy to have that conversation. Ultimately, we are all trying to achieve the same thing. We want to produce more of our own food needs sustainably to do that in Scotland and to ensure that we have strong, local and resilient supply chains and see more of our own produce ending up particularly in the public sector, first of all, where we have a lot of initiatives and a lot of levers that we can use to deliver that. On rural affairs, land reform and islands, there will be a very short pause before we move to the next item of business to allow front-bench teams to change positions should they wish. I remind members that questions 3 and 8 have been grouped together. Therefore, I will take any supplementary questions on them once both have been answered. To ask the Scottish Government how many mothers from Murray it anticipates will give birth at Regmore each year until the new service adopts graces up and running in light of the decision in December 2022 not to continue with model 4. The previous Cabinet Secretary for Health and Social Care approved the plan for integrated maternity services across the north of Scotland with consultant-led obstetric services at Dr Gray's hospital supporting this with an initial investment of up to 6.6 million. While model 4 is not continuing as previously outlined in the Ralph Roberts review, the elements in model 4 continue to feature in the approved plan. Within this plan, Regmore will continue to accept around 1 to 2 women per week who require emergency transfer and labour from Dr Gray's. In addition from 2025 and in line with expected completion of building refurbishment work in Regmore and increased staffing levels associated with the networked model of care, it is expected that Murray women can choose to birth in Regmore in addition to Dr Gray's or Aberdeen maternity hospital. I am expecting to see the revised NHS Highland business case for Regmore maternity services once it has been through board approval processes. I thank the Minister for that answer. NHS Highland is spending £9 million to expand Regmore's maternity unit with the help of a £5 million allocation from the Scottish Government. Can the cabinet secretary explain how Regmore, as it was explained at the board meeting yesterday, will cope with an estimated 500 extra births per year when the updated unit when built will only increase capacity by one additional bed space in the Labour suite area? The plan for a networked model of maternity care in the north, approved in March 2023, envisages women from Murray being able to choose to birth in Regmore from 2025. I am expecting to receive the revised business case, as I previously mentioned from Highland shortly. Although I am aware that it was discussed at the Highland board meeting yesterday and was available online, I will consider it fully and look at the points that the member has raised. While we should not be any doubt about the scale of the challenges in delivering this, it is welcome that the services will now be rebuilt in a phased way in order to ensure that they are safe, sustainable and fit for the future. Given the importance of those developments, will the minister provide assurances that she will keep Parliament updated as the delivery period progresses? Karen Adam makes an important point. The member will be aware that the previous Cabinet Secretary for Health and Social Care reiterated his commitment to returning consultant-led maternity services to Dr Gray's on numerous occasions, and it is also a manifesto pledge. I can give absolute assurance that, as progress is made, I would be happy to keep Parliament updated. To ask the Scottish Government how it is supporting the continuation of the independent contractor model in general practice. The Scottish Government remains committed to supporting general practice. The independent contractor model is a key part of that. I recently met the chair of the BMA's Scottish General Practice Practitioners Committee to reaffirm this. The 2018 GP contract agreed with the BMA, designed to support and strengthen this commitment. As part of that contract to support GP practices, we have recruited more than 3,220 healthcare professionals since 2018. That is underpinned by an investment of £170 million this year, and our policy prospectus commits us to sustaining this investment through the primary care improvement fund and investing more in practices servicing disadvantaged areas. We remain committed to increasing number of GPs working in Scotland by at least £800 by 2027. I thank the cabinet secretary for that sponsor. He will recognise that, although he has promised 800 more GPs, Audit Scotland has warned that progress is not on track. My own region NHS Tayside has recommended that Invergary's practice will close later this month, with over 1,800 patients being allocated to other practices. In Fife, we have seen 40 per cent of GP surgeries close their doors to new patients that are higher than anywhere else in Scotland. Among the current workforce, it is estimated that over a third are unlikely to remain in general practice in five years. That would mean around 1,500 GPs lost. Can I ask what action the Scottish Government is taking to improve the retention of GPs, which will be crucial if we are to reach the required number that we need going forward? There is a range of work that we are taking forward in order to help to support the retention of GPs into general practice through some of the funding initiatives that we have in place, particularly for rural areas, in order to encourage GPs to work in those areas. Alongside that, for example, in our recruitment programme for this year around GP training, we have reached more or less the quarter that was set this year to help to support further GP provision. I want to reassure the member and understand the concerns that she is raising on behalf of her constituents. Investment in primary care, supporting the retention of general practitioners, helping to recruit more into general practice, alongside expanding the primary care workforce, are all critical to making sure we have a sustainable primary care system. That is why, for example, we have recruited more than 3,000 additional staff into primary care to help to support that wider workforce to support individuals with their health care needs in the primary care setting. The cabinet secretary will be aware of the issues that I have raised about the GP surgeries in Burghead and Hopeman having written to him and his predecessor. There is a very strong local action group saver surgeries who are campaigning to retain these vital services, and I believe that there is cross-party support for that. Will he agree to meet with the campaigners, either in Murray or here in Parliament, to listen to their concerns about the future of these two vital surgeries and the solutions that they are offering locally to keep them open? I am aware of the issues relating to those surgeries, and the principal route for those issues to be addressed is through the IJB and the health and social care partnership locally to look at the design of services being provided locally, including through the health board who have a contract directly with the GP practice for those particular services and the decisions that they are making around the existing surgeries that they have in place. It is important that that process is taken forward, and I would certainly encourage the member and those locally to engage with the health board, the IJB and the health and social care partnership to engage in those issues to look at how they can make sure that they have sustainable services going forward. Independent GP contractors in West Lothian have told me that having the ability to directly employ eyed health professionals like physiotherapists, occupational therapists and dieticians would make a real difference, allowing GPs to employ HPs based on the practices' needs rather than on centralised allocations, giving GPs the authority to line manage the HPs in their employ and supporting flexibility, continuity and integrity of care for patients. Currently, our local health and social care partnership requires centralised recruitment and employment. Is this a policy that the cabinet secretary can consider to support GPs' improved services to their patients? I recognise the value that the wider skills group can have to supporting primary care, particularly through the use of HPs for a range of areas such as MSK, physios, OTEs or dieticians. The approach that is taking at present is to try and make sure that we see a steady increase in the HPs being provided across GP practices in the country. I recognise the concern that the member has raised. It is an issue that I have discussed with GP practices in my constituency in recent times. I am not unsympathetic to looking at how we can improve on the existing model that would give GPs some greater control around these matters, but equally I also want to make sure that as we see the multidisciplinary team around primary care expand and develop, I want to also make sure that that is happening on a consistent basis. We see as many GP practices as possible benefiting from that, and some GP practices may want to do that direct to themselves, others may want that to be done centrally for them, but I am simply open to looking at how we can improve the system further. I would like to ask the Scottish Government whether it will provide an update on what it is doing to tackle any challenges faced by NHS dentistry. We are working a pace at moving forward with a modernised system of payment reform that will provide longer-term sustainability to the sector, encouraging dentists to provide NHS care. The new system provides greater clinical freedom to dentists in a high trust, low bureaucracy model. The new policy perspective set out by this Government on 18 April further commits us to sustained and improved equitable national access to NHS dentistry by 2026. That reaffirms our commitment to the sector and to patients in all parts of Scotland. I would like to thank the Minister for that answer. In a month's time, the last NHS dentist in Cunroshir is set to transform into a private practice. This is clearly a challenging issue for the folk living in a vast rural area, and there will now be a lack of accessible coverage for a very important public health service. What more can the Government do to improve access to NHS dentistry in rural areas such as that in my constituency? I recognise the concerns that Jim Fairlie raises. We are working closely with NHS boards, a number of which have appointed task forces, supporting them to develop tailored solutions to help address some of these local access issues. I can also confirm that we have recently expanded the Scottish Dental Access Initiative grant support to Cunrosh. That offers an attractive and unique package of financial support to incentivise the setting up of new practice or extension of existing practice up to a potential of £100,000 for the first surgery and £25,000 per additional surgery. To ask the Scottish Government whether it will provide an update on what action it will take to reverse the reported decline in NHS dentistry. The new policy perspective set out by this Government on 18 April commits us to sustained and improved equitable national access to NHS dentistry by 2026. The previous Cabinet Secretary for Health and Social Security recently confirmed the continuation of the bridging payment to 31 October 2023, while we prepare for the implementation of payment reform. Payment reform will comprise a new model, modernised system, which will provide NHS dental teams with greater clinical discretion and transparency for NHS patients. I'm afraid that another month passes and we've still got no clarity about what the future fee payment system will be for dentists. Meanwhile, we hear from people like Jim Fairlie that dentists are leaving the NHS system. So, when is the Minister going to get a grip of this, bring forward the payment system so we've got more clarity so we can stop the rot in NHS dentistry? I thank Willie Rennie for his question. I'm sure that you will understand that while we are discussing things with the BDA that needs to remain could be confidential, but I will be updating Parliament as soon as I can. The SNP Green Government do not understand NHS dentistry with the Minister saying there's low bureaucracy model. Well, if you're a qualified dentist practicing for many years from abroad or even England, Wales and Northern Ireland and you want to come to Scotland, you have to be recruited as a VTE assistant. That means working under supervision for a year, not independently as a dentist. As a result, we have the frankly ludicrous scenario of highly qualified dentists, often with many years of experience, requiring to work as trainees for a year if they wish to move to Scotland. This deters dentists coming to Scotland. Will the Minister commit to removing this bureaucratic red tape so we can attract qualified dentists to Scotland? The Prime Minister's question is a UK-wide issue, and the Scottish Government is working closely with the other nations. In fact, I'm in the process of writing to them to see if we can find a better process to ensure that we get the right people, the right dentists. Minister, please. The question has been posed and the Minister is responding. We do not need sedentary interventions. There would be other routes. Minister, please continue. I am in the process of writing to the UK Government to work with them in a foreign nation process to try and alleviate this situation. With the accessibility of NHS dentistry declining, oral health inequalities are widening and access to dental care for particularly vulnerable groups such as children and younger people is crucial. Can the minister advise what steps the Government is taking to support the recovery and future of oral health improvement programmes such as the labour legacy of child smile, caring for smiles and mouth matters? I thank Paul Sweeney for his question. I was going to reference child smile as well because I think it's a fantastic project that really helps to educate young children about the importance of oral health. Over the longer term, we've seen significant improvements in child oral health in Scotland. For example, the first year of the national dental inspection programme showed that 45 per cent of primary 1 children—this was in 2002-3—had no obvious decay experience. Despite the unique challenges of the pandemic, that figure has increased to 73 per cent. As of 1 February last year, the Scottish Government introduced changes that permanently increased enhanced fees for examination appointments for both adults and children for the first time dentists would receive a fee for examinations for children. The minister of what the Scottish Government is doing to proactively encourage the use of digital dentistry and particularly oral scanners, which offer significant time saving for dentists' increasing capacity, cost savings for the health service and economic development opportunities for Scotland's life science sector and prevent Scotland falling behind global best practice in this regard. I think Ivan McKee raises a really important point, but I would also remind the chamber that NHS dentistry is provided by independent contractors and the use of digital technology is ultimately a business decision for them. The use of digital technology in dentistry is becoming more commonplace and I very much welcome this. It affords potential cost savings for dentists and also improved patient experiences. I am confident through the payment reform we are enabling dentists to make the use of digital technology where they deem it appropriate, for example by using digital scanners rather than taking physical impressions of teeth. Does the minister accept that dentists are aware of all the policy initiatives that she talks about, the fact that payments are continuing until 31 October that a new payment regime is coming into place, but they are still choosing to withdraw from NHS provision? Over 20,000 patients alone in Dumfries and Galloway have been deregistered from the NHS recently, so why does the minister think that that is happening if this new regime is going to solve the problems? I think that payment reform constitutes one of the national responses that we have for dentistry. It is our intention that, with putting in this framework of payment reform, we will lay the foundations to ensure further engagement with dentists looking at the points that you have raised. Question 4 was not lodged. Question 5, Stephanie Cameron. To ask the Scottish Government whether it can provide an update on any decent engagement with health and social care ministers from the other UK Administrations regarding a co-ordinated approach to dentistry. A co-ordinated approach is often not possible as dental services in Scotland operates on a fee for item of service model, which is entirely different from the contract model used in England and Wales. However, where we identify areas of mutual concerns such as workforce, then the intention is to raise this with UK Government colleagues. I welcome the comments from Jenny Minter earlier this month confirming extended Scottish Dental Access Initiative grants and enhanced recruitment retention allowance. Importantly, the minister also noted that she was working with and writing to the UK Department of Health and Social Care ministers to seek improvements of the registration process for overseas dentists in a four-country basis. Can the minister provide an update on any progress made with this work to increase dentistry workforce pipelines for overseas? Does she agree that this work is vital to address the destructive impact of Brexit and improve oral healthcare for patients? I thank Stephanie Callaghan for her question and I think that she makes a really important point around the impact that Brexit has had on dental workforce in Scotland. The Scottish Parliament approved legislation which came into force on 8 March 2023 and provides the General Dentist Council with flexibility regarding international registration. As Stephanie Callaghan mentioned, I am in the process of writing to the Department of Health ministers to ensure that changes are made on a four-nation basis to improve the registration process for overseas dentists. I can also confirm that the cabinet secretary will raise this with the GDC and he meets with them on 15 June. To ask the Scottish Government when it last met with NHS Lanarkshire and what was discussed. Ministers and Scottish Government officials regularly meet with representatives of all health boards, including NHS Lanarkshire, to discuss matters of importance to local people. We are seeing some really positive changes in primary care, with an emphasis on getting the right care in the right place. For example, pharmacy first is an excellent policy which allows pharmacy teams to provide advice, treatment and referrals. However, we know that people are really struggling to get appointments with their GP. Can the cabinet secretary outline some of the wider work being done to improve primary care and how that modernisation will continue to benefit patients? In terms of GP practices, can the cabinet secretary set out how standards are set and monitored, including ease of booking appointments? What opportunity do members of the public have to give feedback? The member raises an important issue on behalf of her constituents. As I mentioned earlier in response to another question, we have saw a significant expansion in the primary care team through over 3,000 additional staff being recruited to help to support primary care, which includes staff from an HP background. We want to see that continue to expand as we move forward. I am also aware of the wider services that are offered by the wider primary care network, for example, through pharmacy and also through opticians, which can all have a positive impact on how patients can access to particular services in their own locality. The member may also be aware that the former Cabinet Secretary for Health also set up the general practice access group, which is looking at some of the key principles around access to general practice. That work is on-going, and we expect to receive that report in the coming months. I hope to be in a position where we can publish it in the summer. The member will also be aware that, as independent practitioners, practices have to have arrangements that ensure that they comply with the GP contract in their health board area and how they ensure access to patients. Therefore, any patient who is having concerns about access to their GP services can raise it directly with them or via their health board. It is important that GP practices are providing access to patients so that they can make appointments as and when it is necessary. The cabinet secretary will be well aware of the problems that Lanarkshire's A&E units have been having. In March, just 57.2 per cent of patients in Lanarkshire were seen within four hours. At Hermey's hospital in East Kilbride, this figure was 52.3 per cent. That is against the national target of 95 per cent. Staff have been up against it for months. What is the cabinet secretary going to do to help them to reach the national target? There is a range of work that the health board is taking forward, which I am sure the member will be aware of. For example, the recent firebreak work that has been taken forward in order to help to improve capacity within the A&E department and also with the flow of patients through the hospital. They have had some positive impact from that, and we hope to see further progress being made with that. Alongside that, we are providing support and guidance to boards to help to ensure that they are doing everything that they can in order to improve flow of patients that have an impact on A&E performance, including the use of the glass flow model, which at the present time NHS Lanarkshire is looking to roll out in order to help to improve the way in which patients move through the hospital at times as well. Those combinational factors should help to support staff and also help to improve performance going forward. To ask the Scottish Government whether it will initiate an independent review into the use of surgical mesh products within NHS Scotland. The Scottish Government has already commissioned an independent review on transvaginal mesh implants and acted on the conclusions that were published in March 2017. We have also implemented Barnais Cumberlage's 2020 recommendations about transvaginal mesh. We have more recently commissioned two reports from the Scottish Health Technologies Group on mesh used in hernia repair. Those reports supported its continued use but stressed the importance of patient choice, availability of alternative treatments, informed consent and data collection, all of which the Government supports. Freedom of information responses showed that, from 2015 to this year, 8 per cent of all patients in NHS Ayrshire and Arran who are implanted with surgical mesh to treat a hernia were readmitted due to complications arising from the mesh. That suggests that there may be a connection between surgical mesh products having a detrimental impact on the health of some hernia patients. Will the Minister meet with campaigners who are calling on the Scottish Government to undertake an independent review into the use of mesh? I thank Katy Clark for her supplementary question and appreciate the concerns that this must have for her constituents. Scottish Government officials have previously offered to arrange a meeting between a small group of Katy Clark's constituents and the Scottish Health Technologies Group in order to discuss the findings of their reports into hernia mesh. That offer remains open should they wish to take it up. Minister, action needs to be taken now to support women who have been affected by transvaginal mesh related health issues. The median weight for referral to the complex mesh surgical service in Glasgow is 236 days and the longest weight is 448 days. Women then need to wait a significant length of time to start treatment that will alleviate or even remove their symptoms if they are fortunate. Women with this debilitating and life-altering condition need help now. What action is the Government taking to accelerate the provision of this vital treatment? I thank Sue Webber for her question. The Government has taken note of the results of both the health committee's survey and one done by Greater Glasgow and Clyde with regards to this. We are looking at improvements that can be made. Surgeries have started or have restarted and a number have been carried out. The service expects that it will soon be able to operate within 12 weeks of the patient and her clinicians deciding upon that course of treatment. I can confirm that the service is also taking action to increase its outpatient capacity, which includes an additional translabial scanner, that will allow more patients to be seen and I hope that progress from those actions will start to become evident. That concludes portfolio questions on NHS recovery, health and social care. I would like to take this opportunity to respond to Mr Kerr's earlier point of order. I understand that the established practice is for documents to be published at the start of the debate to ensure that information does not enter the public domain before it is provided to members. I understand in this regard that embargo copies were indeed provided to assist members in their preparation for the debate and I hope that that is helpful clarification for members. There will be a very short pause before we move on to the next item of business.