 G I will call on Joffus Patrick to move motion 9292. Formally moved. Thank you very much. No one has asked us to speak against the motion. The question is that motion 9292 be approved. Are we all agreed? Yes. Thank you very much. We move on now to portfolio questions and we start with question number one from Lewis MacDonald. Thank you very much. To ask the Scottish Government how it will provide sustainable funding in the future for the Scottish Sports Association. Minister Eileen Campbell. Thank you. The Government has a strong relationship with the SSA and appreciates the support they provide to Scottish sporting governing bodies. The SSA is a membership organisation made up of sporting governing bodies and we root funding to support our SGBs through Sport Scotland and we do not provide core funding to the SSA. In financial year 2017-18 we provided funding to the SSA to carry out a short term project focused on assessing equalities issues within SGBs as well as work supporting the Government to identify grass-roots nominations for the hon. process. Lewis MacDonald. I am glad that the minister appreciates the importance of the SSA as the independent voice of Scottish sport and I hear what she says about 2017-18. My question was about sustainable funding for the future and I know that the minister went to the AGM of the SSA last year and made a commitment as minister to ensuring that the SSA would have sustainable funding for the future. Does she recognise that the fact that the funding both directly from Government and Sport Scotland is now planned to be cut? Does she recognise that that falls short of the commitment that she gave and will she review the funding position to ensure that the SSA has the funding that it needs to continue to act as the independent voice of Scottish sports? I attended the AGM last year and we made that commitment to provide funding for the SSA to carry out that short-term project and work with it to enable it to secure additional sources of funding. We absolutely respect the right of governing bodies to come together under a representative body and recognise that, while the SSA does not represent all governing bodies, some members of the SSA value that collective voice of the governing bodies role played by the SSA. We recognise that they continue to ensure that they articulate the voices of our governing bodies of all different sizes. Our relationship with the SSA is strong, but we do not provide core funding. That is why we provided that support last year in order for them to do that specific bit of work. We continue on that basis to look if there are ways in which they can provide additional information to us or work with us collaboratively to enable us to work towards ensuring that we create the act of Scotland that we all seek. Further to Lewis MacDonald's question, does that mean that the minister plans to find a way to fund the SSA in the forthcoming financial year? As I said, we do not provide core funding to the SSA. We root our funding to support our governing bodies through Sport Scotland, and the SSA is a membership organisation made up of those governing bodies. We reiterate what I said to Lewis MacDonald to respect the right of governing bodies to come together under our representative body, and we will continue to work with the SSA to explore avenues for them to have a sustainable financial future. We will continue to engage with members who have a particular interest in that. I know that there are lots of bits of correspondence coming to us and from MSPs across the chamber, and we will continue to keep them updated on the progress that the SSA makes. Fulton MacGregor. I put on record my apologies for coming in slightly late for Lewis MacDonald's question. The national lottery income for good causes was reduced by 14 per cent between 2015-16 and 2016-17. Will the minister agree with me that UK Government's lack of action to address this important issue is putting the delivery of sports at risk? I am a bit surprised as to why there were groans across the chamber. Consider that many people will come to the chamber and continually ask me to provide support for funding. Given that we all know that the national lottery is an important source of funding available to sports Scotland, and given that we know that there is a financial year that the income is expected to be 26 per cent lower than in 2015-16, all those cries and moans from across the chamber is a complete surprise, because we absolutely need to recognise that this is a challenge. That is why, on 7 November, along with my colleague the Cabinet Secretary for Culture and Tourism and External Affairs, we sent a joint letter to the UK Government, highlighting the impact on both the sport and cultural sectors and the concern that, at that point, the UK Government was failing to act to address that issue. I have now received a response to that letter from Karen Bradley talking about how she will be looking to bring about some improvements, but I will continue to monitor that situation and raise that issue again when I next meet the Parliamentary Undersecretary for State for Sport, Tourism and Heritage. Despite the groans, Fulton MacGregor is absolutely right to raise that issue, because it is a real concern for many good causes across our country. To ask the Scottish Government what it is doing to ensure that sport is funded to enable access for all. Government remains committed to helping Scotland to be more physically active, providing the right facilities in the right places and ensuring our world-class sporting facilities cater to performance athletes and local communities alike. We are committed to ensuring that sports facilities are affordable, accessible and inclusive to people who want to get involved and stay involved in sport. For example, there are now better and more opportunities for people of all ages and abilities to participate in sport and physical activity across Scotland, with 181 community sports hubs up and running, increasing to 200 by 2020. In 2017 alone, we have provided sports governor bodies with an additional £2 million specifically to target work on equalities, to establish the £300,000 sporting equality fund, establish the Women and Girls and Sport advisory board to drive female sports participation, invest nearly £1 million to support older adults in care to become active, and we formally opened the Sports Scotland national sports training centre in Recklide, offering world-class sporting facilities and services that will have a positive impact to users at all levels of physical ability. Brian Whittle I thank the minister for that answer. However, in the back of withdrawing funding to ensure all primary school pupils have the opportunity to learn to swim, the debacle with jog Scotland when funding was only reinstated after much lobbying and the reduction in the sport's budget by some £4 million last year, we now hear that the Scottish Sports Council, which is the direct link between government and sport, has had its funding withdrawn. How can the minister possibly state that the Scottish Government is committed to sport and activities for all, with the implications that it has on the preventable health agenda, when it seems hell-bent in cutting every budget that has a positive effect on the health of the nation and tackling health inequalities? Aileen Campbell On the back of that question to me, I do not really understand why he grown so much when Fulton MacGregor made a perfectly reasonable point about recognising the impact that the reduction in national lottery income will mean for sport and activity across the country. I outlined a range of work that we are taking forward to ensure that sport and opportunities and to be active are available to everybody across the country. Of course, there are still more things that we need to do. Aside from that, Brian Whittle continually comes to this chamber looking for us to always come up with the answer to some of the issues around inequalities. I hear that he says that we are the Government. Is this Government that continually has to pick up the pieces for the mess that his Government, down at Westminster, continually leaves behind? Is this Government that has a child poverty act? Is this Government that is trying to ensure that people with disabilities in the country are treated with dignity? Is this Government that has provided a sporting centre in Inverclyde that will now people with physical disabilities to be able to take part in sport of their choice? Unlike his Government, unlike Brian Whittle, I do not think that we will take in any lessons from Brian Whittle or the Conservatives of the United Kingdom. To ask the Scottish Government what NHS workforce planning is undertaking in relation to the potential impact of Brexit on staffing levels. All of us in Scotland benefit enormously from the contribution made by NHS staff from across the European Union. The free movement of people from the EU and the EUA allows skilled and experienced health professionals to work here, providing safe, high-quality services to Scotland's people. The possible impact of Brexit on staffing levels within the NHS will depend on the precise form of withdrawal from the EU imposed by the UK Government. The nursing and midwifery council reports that significantly fewer EUA nurses are registering in the UK, and the BMA also reports that many EUA-trained doctors are considering leaving the UK. However, we may remain fully committed to continuing to recruit EUA healthcare staff, and we will continue to work hard to protect their rights and place here in Scotland. Julian Martin Cabinet Secretary has already alluded to the nursing and midwifery council who have claimed that European staff are already leaving the UK in their droves. Latest statistics show that 4,067 nurses in the EU left a job last year, a rise of around 67 per cent from the previous year, and an 89 per cent fall in the number of nurses coming to the UK to work from EU countries. Brexit has not even happened yet, and the NHS has failed its impact. Will the cabinet secretary outline any assessment that she has done on the scale of the staffing crisis that could envelop Scottish NHS and give detail on what contact she has had with the UK Brexit minister and the Home Secretary to impress the urgency of clarity on their future immigration policy? The figure is cited by Julian Martin, who is very concerning indeed. That is why the Scottish Government has repeatedly called on the UK Government to provide an immediate guarantee of the rights of all EU citizens living here. On 1 September, I wrote to the UK Government Home Secretary and the Health Secretary to signal my concerns about the approach that has been taken to Brexit and the uncertainty that the UK Government's position on Brexit is creating for EU nationals and their families and how it is compromising our ability to recruit and retain talent. The Scottish Government believes that maintaining free movement of persons as part of the single market is in the best interests of the UK as a whole and of Scotland. Of course, we are doing what we can to increase staffing here, and we have increased staffing by over 9 per cent and the number of qualified nurses in midwys has risen by 5.6 per cent under this Government, and we have plans to continue to increase the supply of health staff. However, my cabinet colleagues and I will continue to press the case for further clarity, because that will certainly damage our potential of recruiting from outwith Scotland in order to ensure that we maintain quality services here in Scotland. Miles Briggs I think that it is clear for all involved in this debate to realise that NHS Scotland's workforce problems did not begin on 23 June 2016. They have been presided over by this Government for 10 long years. Given that Audit Scotland has said that the Government's long-awaited workforce plan is not, in fact, a detailed plan after all, merely a broad framework, what plans does the cabinet secretary and the Government have to increase the number of nurses in our hospital wards? Of course, Jeremy Hunt and I recently don't even have a workforce plan for NHS England, and I'm very happy to share our plans with Jeremy Hunt to get him on his way of delivering and developing a workforce plan. As Miles Briggs will know, we have already published part 1 of the plan. The social care plan is imminent, and the primary care plan will follow once we have a decision on the GP contract going forward. We have already expanded nursing training places 2,600 by the end of this Parliament. We are expanding medical education with the graduate medical school, and we have more training places for medics. In addition, we are taking the action here. Miles Briggs likes to dismiss the issue of Brexit, because it is uncomfortable for him to acknowledge that that will only add pressures—not just here in Scotland, but the rest of the UK—on our NHS and care services. Perhaps he would do well just to acknowledge that. To ask the Scottish Government what it is doing to raise awareness of the symptoms of pancreatic cancer. Through our detect cancer early programme, we aim to increase the proportion of cancers that are detected at the earliest stages. Central to this is our social marketing strategy, and next year the programme will focus on the overall benefits of early detection for all cancers, and aim to encourage anyone with any concerns or changes to their body to visit their GP. We are also committed to supporting GPs to be more aware of the potential signs and symptoms of cancer, and we have updated the Scottish referral guidelines for suspected cancer in 2014. More recently, that has been supported by the development and launch of an app in 2016. My officials are in discussion with Pancreatic Cancer UK to discuss how we can support awareness messaging through our WeC strategy and social media and digital channels. Clare Adamson Thank you, cabinet secretary, for her answer. Pancreatic Cancer UK carried out a survey that showed that 35 per cent of adults in the UK would not be worried if they had several of the potential symptoms of pancreatic cancer. Does raising awareness through events such as Pancreatic Cancer Month, which was just had light at our purple, and raising awareness of this cancer, which has not seen significant changes in outcomes as other cancers have? Does she support those campaigns going forward? Clare Adamson Yes, I very much do support those campaigns. The lighted up purple campaign is a way of raising awareness among the public. We know that the earlier a cancer is diagnosed, the easier it is to treat. We recognise that the signs and symptoms of pancreatic cancer can sometimes be vague and nonspecific through the collaboration with the Scottish primary care cancer group and third sector colleagues such as Macmillan Cancer Support. We are commissioning a refresh of the Scottish referral guidelines for suspected cancer to take place in 2018 to ensure that any new and emerging evidence is considered. That will be supported by the development of education and training on early diagnosis for primary care colleagues. I hope that that will make a difference in making sure that we can get people into treatment earlier than we do at the moment. Tom Mason There are problems with detecting late detection of pancreatic cancer. It is vital that these detections are done as quickly as possible. However, according to the latest figures, one in eight of cancer patients are waiting more than 62 days for urgent treatment. Although we have just heard from the cabinet secretary some measures to counteract this, they are rather woolly. Can you be more specific and get that waiting time down well below 62 days and what can we expect in four years' time? I do not think that my answer was woolly. I was laying out some of the work that we are doing to make sure that people are treated earlier by early detection. The 62-day treatment that Tom Mason outlines, I have already said very clearly that we need to make improvements there. That is why we are investing additional funding into diagnostics. Once people are diagnosed, treatment for cancer takes place on average within six days, so the issue is improving diagnostics. That is why I am chairing personally the cancer improvement group, which is looking at rolling out some of the best practice that we see, for example, in NHS Lanarkshire, where they are meeting the 62-day target. What I would say is that, for some of the complex cancers, the staging and the treatment are not always straightforward. That is why the 62-day target only applies to some cancers because of that complexity in treatment. I am very happy to write to Tom Mason if that would be helpful to him in understanding some of those more complex issues. To ask the Scottish Government how many orthopedic patients are waiting longer than the guaranteed waiting time limit of 12 weeks to receive treatment. In the quarter ending 30 September, 4,060 patients had waited longer than 12 weeks for orthopedic surgery, with 5,071 patients being treated within the legal guarantee. I recognise that some patients are experiencing long waits, which is why I have made £150 million available to the NHS over the next three years. £50 million has already been allocated to boards in the current year, and that additional funding will build up capacity and make sure that all patients are seen untreated in a timely fashion, including in the specialty of orthopedics. I expect to see improvements between now and the end of March next year. There are challenges in NHS Glasgow and Clyde, and they have been funded with an additional £500,000 to improve orthopedic waiting times between now and the end of March. They expect to deliver significant improvements in waiting times through hip and knee replacements in the Golden Jubilee national hospital, as well as additional internal orthopedic activity. I thank the cabinet secretary for her response and her recognition that the treatment time guarantee means very little for those who are waiting longer than 12 weeks. I have many constituents, as she knows, who have waited much longer than even a year for treatment. The cabinet secretary has indeed announced £50 million to improve waiting times in May. That is welcome—11 million of which is for NHS Greater Glasgow and Clyde. That was May. We are now seven months on, and people in my area are still waiting far too long. Can she guarantee that we will see an improvement so that my constituents no longer need to wait beyond 12 weeks in pain for treatment? I say to Jackie Baillie that, indeed, NHS Greater Glasgow and Clyde has received £11.2 million of that £50 million. As she will appreciate, it takes time to build up that capacity. However, I can tell her that the boards' feedback—not just NHS Greater Glasgow and Clyde, but other health boards—is telling me that they are seeing some of those longest waits now reducing. I am confident that, between now and March, we will see further improvement on that. We have asked boards to tackle the longest waits, and I am certainly very clear with boards that they have to do so. I have laid out in my answer to Jackie Baillie specifically the fact that we have given additional funding of £500,000 to help Glasgow to make the further improvements that they need to make between now and the end of March, because of the types of cases that Jackie Baillie has raised. I will try to step in for Jackie Baillie. I am very grateful to Jackie Baillie, who is the experience of whose constituents very much mirrors those of my own in Orkney. The cabinet secretary should be aware that capacity problems in NHS Grampian have led to similar delays, but is she aware that NHS Grampian appears to be sending out patient letters now, offering appointments that have to be confirmed within a two-week period via a helpline that itself is very busy, only available 9 to 5 Monday to Friday? Does she think that that approach, passing the onus back on to patients in confirming appointments, is the best way of reducing the waiting times, which, by her own acknowledgement, is far too long? I will say to Liam McArthur that what NHS Grampian is doing is to try and manage its capacity as best that it can and to ensure that every patient or every appointment opportunity is utilised. What it is also doing—I will come and write the chief executive of NHS Grampian—is working across the whole of the north area, with NHS Highland in particular, to look at how they manage the capacity across the whole of the north of Scotland, particularly when it comes to elective and outpatient appointments. That is a very good move, because we need to look at new ways of working. In addition to that, the work that Derek Bell is taking forward in reforming the way that we deliver elective procedures and outpatient appointments will ensure that we have used our capacity in the most effective and efficient way. I am a constituent who has been waiting a number of months for a specialist appointment. The appointment was in touch with me yesterday, after having received once again a call from the Ambulance Service, cancelling a booking to take him to hospital for an appointment today. Does the cabinet secretary agree that cutbacks in one area of the service are making waiting times worse and hindering the efficient working of the wider services? In those cases, surely, where a cancellation is made at such short notice, arrangements for a taxi service should be made? I am concerned to hear that. It is not good for patients to have their appointments cancelled at short notice. I am not clear from what Mark Griffin is saying whether that is an issue for the Scottish Ambulance Service. If it is, what I would be keen for him to do is to write to me with the circumstances, and I would certainly want to look into that. It is very important that we have a joined-up service here where someone has an appointment, so that appointment is kept. If it is an issue of transportation to that appointment, we need to get that resolved. If Mark Griffin wants to write to me with the detail of that, I will certainly look into that case. 6. Alex Cole-Hamilton To ask the Scottish Government what it is doing to support and provide resources for organisations that promote healthy lifestyles. The Scottish Government has taken forward a wide range of actions, including funding in many key policy areas to encourage physical activity, improve diet and mental wellbeing, as well as initiatives to tackle alcohol and substance abuse. We aim to ensure that people in all of our communities, particularly children and their families, have the knowledge and skills to make healthy living choices. Alex Cole-Hamilton I thank the minister for that answer. As we have heard, the Scottish Sports Association plays a vital part in connecting the value of sports in our communities with our efforts to improve the health of our nation through policy in this place. Does the minister not consider that the withdrawal of funding from the SSA could be perceived as a cynical attempt to silence what is in essence the voice of sports in our communities before further budget cuts to sports are announced? Will the minister listen to the consensus that has been established across the Opposition benches this afternoon and directly fund the association going forward? Ruth Davidson Thank you. I reiterate what I said already in previous questions. The SSA is a membership organisation that is made up of sport and governing bodies, and we root funding to support our governing bodies through Sport Scotland, and we do not provide core funding to the SSA. However, we have a strong relationship with the SSA, and that is why, last year, we provided funding to the SSA to enable them to take forward some short-term focused work. We will continue to listen to other male position members and we will continue to listen to any other representation going forward. However, I reiterate that that was not core funding. That is done through their membership organisations and we root our support to governing bodies through Sport Scotland. John Mason Thank you. To ask the Scottish Government what discussions it has had with NHS Greater Glasgow and Clyde regarding the planned upgrade of the Parkhead hospital site. The Scottish Government's plans for the Glasgow East End Health and Social Care Centre are at a relatively early stage and are currently being developed by NHS Greater Glasgow and Clyde and Glasgow City Health and Social Care Partnership. The Scottish Government is supportive of the project in principle, and we are keen to review the plans as they develop. John Mason Thank you, cabinet secretary, for that answer. Would she accept that residents in the east end of Glasgow are very resistant to travelling to Stobhill in the north of Glasgow for health facilities? Would she agree that it might help health outcomes in the east end of Glasgow if we had more facilities in the east end of Glasgow? The member will be aware that I met local stakeholders back in September as part of my consideration of the major service change proposals for local rehabilitation services, including Lightburn hospital. I assure John Mason that I am fully aware of both the significant levels of deprivation in the local area and the understandable concerns about appropriate access to services, including the issues around public transport. I intend to make my decision in respect of the major change proposals in the coming weeks. As I said, I welcome the commitment from the board and its planning partners to develop as a priority a health and social care hub in the east end of Glasgow for the benefit of local people. To ask the Scottish Government what action is taking to reduce levels of drug use. We continue to take forward a range of initiatives to tackle problem drug use. We invest significant resources in education and prevention work and will shortly be issuing good practice guidance to the sector based on recent work looking at the effectiveness of education and prevention initiatives. We also work closely with Police Scotland and the UK Government to limit the supply of illicit drugs in Scotland and to support the effective implementation of the relevant legislation. Yesterday in the chamber I outlined my plans to introduce a drug and alcohol treatment strategy. This will seek to address the challenges that we face in our attempts to tackle problem drug and alcohol use, while ensuring that we continue to provide high-quality person-centred services that meet the wide-ranging needs of those that are most at risk from those substances. I thank the minister for that answer, but I think what we need here is a bit of urgency. Worryingly, Dumfries and Galloway has the highest percentage of drug-related hospital admissions in Scotland. The number of people dying from drug overdoses in the area has reached a record high. Families are suffering and people are dying. What measures are the Scottish Government going to take in the here and now to tackle drug misuse in rural areas? Again, I reiterate yesterday that, because of the rise in drug-related deaths, there is a real need for us to work out what we do better to enable those people to feel supported. That is why yesterday I set out that we are developing our seek-keep-and-treat approach, which is to understand the vulnerable cohort of ageing drug users that present in the tragic drug deaths that we see each year. Again, the member is right to recognise that there are particular issues in rural Scotland. Again, I am happy to meet him if he would like to take that opportunity as we seek to develop that refreshed approach to make sure that we have a focus in on the rural issues that he, as a constituency member of Dumfrieshire, wants to outline. Again, I am a rural MSP, and I understand that sometimes services are not always on your doorstep. That is why it is important that we have the flourishing recovery communities across the country, some of them in rural parts of our country, to allow them to feel that they are supported and to help them on their recovery journey. Again, that is an open opportunity for David, not David, sorry, Oliver Mundellus, to take-ups, because it is a really important issue, and there is an opportunity for us to work together to ensure that this has the cross-party support that we had last time when we presented road to recovery. To ask the Scottish Government what it is doing to recruit and retain GPs in not NHS Ayrshire and Arran. We know that GP recruitment and retention is an issue for some areas of Scotland, and that is why the groundbreaking new GP contract for Scotland jointly designed and agreed with the British Medical Association will help to ensure that GPs are able to spend more time with patients and less time on bureaucracy. If accepted, it will help to reduce doctors overall workload and make general practice an even more attractive career prospect by allowing GPs to focus on the patients who need them most. Not only that, but we have committed to increasing funding directly into general practice by £250 million by 2021, including more than £71 million this year as part of a commitment to increase primary care funding by £500 million. We have also increased funding for GP recruitment and retention by £5,000 to £5 million, and in Ayrshire and Arran we have invested £400,000 of that GP recruitment fund to develop new posts with a special focus on particular subjects. We have successfully recruited four GPs who start in posts this year. Jamie Greene I thank the cabinet secretary for that response. It is all very warm words, but the reality is that the Scottish Government's GP recruitment and retention programme has only managed to attract three GPs to work in Ayrshire and Arran. We know that FOI figures show that the health board is paying up to £800 per day for local GPs to cover those shifts. Does the cabinet secretary really think that is an effective use of our health budget? What does she have to say to my constituents in Ayrshire who have lost their GP? I would say to Jamie Greene, as I have said to other members in this chamber, that the recruitment and retention fund has funded a number of projects that are supporting not just the direct recruitment of GPs but support structures around them. Instead of complaining about that, I would have thought that Jamie Greene might have welcomed that additional investment. We are working very hard with the BMA to bring in a new era for primary care and a better deal for GPs. I hope that Jamie Greene and his Tory colleagues will get behind that new contract, because it is a once-in-a-lifetime opportunity to set general practice for the future of Scotland. That will make it a very attractive career for young doctors who are making their decisions about which specialty to go in, but maybe we need to talk up general practice a little bit more than we do. Cabinet Secretary, the Tories have been frightening the old and sick in West Kilbride, my constituency, by saying for weeks that surgery will close and, in fact, a new GP is due to join the practice on 1 January and are post-funded for two years by the GP recruitment and retention fund. Further more, NHS Ayrshire and Arwst currently runs the practice and is inviting tender bids by GP partnerships to take over. Does the cabinet secretary agree that, since taking over West Kilbride medical practice in August, NHS Ayrshire and Arwst has made significant progress, which they should be commended for, and that there is no intention whatsoever to close the practice? Can she also reassure patients and practice staff alike, in the rumours, to the contrary, are untrue? Kenny Gibson is correct. The West Kilbride practice will not be closing its doors to patients and we should be highlighting the positive work that is under way to support that practice, since the board took over in August 2017. Kenny Gibson makes a good point. We should be talking up our GP services and making it an attractive place to come and work, whether that is in Ayrshire and Arwst or anywhere else in Scotland. Ayrshire and Arwst have worked very hard to ensure that the West Kilbride practice has a good and stable future, and I am very happy to write to Kenny Gibson with any further details that he might find helpful. Colin Smyth, just as there is growing demand for GP services in North Ayrshire and Arwst, there is also growing demand for other services, not least chemotherapy. That service has been under review since 2014 and in 2015 NHS Ayrshire and Arwst completed an options appraisial, which implemented will lead to the loss of chemotherapy care at Air Hospital, forcing local cancer patients to travel up to 100 miles for treatment in Ayrshire. Given that it is now three years since that options appraisial was carried out and in the meantime demand continues to rise, and given that NHS Ayrshire and Arwst have not yet consulted on their proposal, will the health secretary intervene and urge the health board to drop this damaging and clearly unpopular proposal? I have spoken recently to John Burns, the chief executive of Ayrshire and Arwst, about the matter in order to get an update. It is, of course, for Ayrshire and Arwst, as it would be for any local board to take forward their local services, but John Burns is keen to see the chemotherapy service as part of the development of the west of Scotland cancer services. He is well aware of the strength of feeling and what is important, as I have made very clear to him and my call to him, is that he consults properly with local people taking into account their views and considerations as they move forward with proposals, whether that is for this service in Ayr hospital or any other across Ayrshire and Arwst. 10. Gordon Lindhurst To ask the Scottish Government what impact engaging in sport and leisure activities has on mental health. Our vision is of a Scotland where more people are more active, more often, in part because being active is good for mental wellbeing. The active living becomes achievable programme, a collaboration between the Scottish Government and mental health charity, SamH, which builds on the well-established links between physical activity and improved mental wellbeing, as well as physical health. It is further evidenced by the recent partnership announcement between SamH and Jog Scotland, which recognises the clear link between physical and mental health. For that answer, she will be aware of physical activity programmes such as the Healthy Act of Mind's project run by Edinburgh Leisure to assist those facing stress, anxiety and depression. Does she welcome the fact that rates relief for leisure trusts will now be continued to allow for the provision of services like those, thanks to Scottish Conservative pressure? Will she lobby colleagues to ensure that adequate funding is given to local authorities to allow for their long-term sustainability? I have to laugh at the fact that the Tories managed to get the rates relief on sport and leisure facilities, as if we had not been working with our colleagues to take forward and look specifically at what was in their Barclay review, which, of course, we are going to debate later on. Question 11, Murdo Fraser. Mr Zann, Scottish Government officials regularly meet with representatives of all boards, including NHS Tayside, to discuss matters of importance to local people. NHS Tayside has a plan to remove all emergency surgery from Perth royal infirmary and move it to Ninewell's in Dundee. That is a plan that has caused serious concern among many residents in Perth and Kinross. In relation to the impact that the decision might have on the future viability of the accident and emergency unit that exists at PRI, what assurances can the cabinet secretary give my constituents today that under this Government to the A and D unit in Perth has a secure future and will not be downgraded or closed? NHS Tayside has given a clear commitment that urgent unschedule care will continue to be provided from the PRI, because the PRI is a very important district general hospital, a very important part of the infrastructure of the NHS. Therefore, I would hope to get rid of any scaremongering that might have been taking place around that issue. Of course, the member is aware that NHS Tayside has been carrying out a consultation about the delivery of surgery across Tayside. The board has been clear that no decisions have been made and that any proposals agreed by the board that are major change will come to me for a final decision. I would carefully consider all available information and representations made before reaching my decision. What is important is delivering safe patient care. That is the most important thing here. In terms of the emergency general surgery, I understand that the board took this temporary measure to ensure that it could continue to provide a safe and appropriate level of care to its patients. I am sure that that is something that Murdo Fraser would understand. To ask the Scottish Government what the difference has been since 2007 between NHS Grampian's actual funding and the amount that it should have been allocated under the NRAC formula? When the NRAC formula was introduced in 2009-10, NHS Grampian was 3.7 per cent behind its target funding allocation. The Scottish Government has invested significantly in supporting those boards behind parity. In 2017-18, the Scottish Government invested an additional £50 million of NRAC funding, which takes all boards for the first time within 1 per cent of their target allocation. Since 2015-16, NHS Grampian has received an additional funding of £47 million for the specific purpose of accelerating NRAC parity. To answer the question that I asked, it is £165 million. That is the amount of money that the Scottish Government has not given NHS Grampian since the NRAC formula. That is the information from the neutral Scottish Parliamentary Information Centre. If she would ask her officials to contact SPICE just to make sure that I am not misunderstanding her answer that it is £165 million, which NHS Grampian should have received and has not, and it is already, even without the NRAC formula, the worst funded health board in the country. If I recollect, the Labour Liberal Democrat Administration did nothing about making sure that NHS Grampian's funding was brought into line. NRAC formula is there in order to make sure that issues such as deprivation are reflected in the funding that boards receive. Under this Government since 2006-07, since Mike Rumble's party was in administration, NHS Grampian's budget has increased by £315 million to almost £900 million in 2017-18, an increase of 54 per cent. In addition to that, we are investing £128 million this year to support the delivery of service reform, and NHS Grampian is, of course, benefiting from that as well. The NRAC formula reflects the most objective measure of funding equity that we have developed. It takes explicit account of demographics, deprivation and geography in order to promote equity of access to health services for all residents across Scotland. Thank you. I thank the ministers and members. That concludes health questions. We will move on to a statement on policing. We will just take a few moments for the ministers to change seats.