 The first item of business this afternoon is portfolio questions on health, wellbeing and sport. Question 1 is from Mary Scanlon. To ask the Scottish Government what is being done to ensure early diagnosis and appropriate on-going support for mental health patients. Minister, Jamie Hepburn. NHS boards and their partners work together to ensure all those who need access to mental health services can do so quickly and efficiently in line with their statutory duties and Scottish Government policy. We are making progress and delivering the commitments in the national mental health. Dementia has suicide prevention strategies that support early diagnosis and faster access to treatment. For example, setting waiting time targets for psychological therapies and child and adolescent mental health services and improving post diagnosis support for people with dementia. Given that 30 per cent of GP consultations are mental health related and that GPs have minimal if any training in mental health, how can patients be assured that they get the right diagnosis and appropriate referral to specialists, and what is the Government doing to ensure that GPs are given the support and training to diagnose and advise 30 per cent of their patients? For me to second guess the clinical judgement of our fully qualified medical professionals is that we should recognise that GPs are provided with substantial training in terms of the expertise across the range of health services that they have to deliver. We will always be keen to do more, particularly in relation to mental health services. There is a range of activity already happening out there and we are always willing to hear new innovative ideas. 2. Rob Gibson Thank you, Presiding Officer. To ask the Scottish Government what funding is available for minority sports. Minister, Jamie Hepburn. Sportscot and the National Agency for Sport Invest Scottish Government and National Lottery Funding and recognised Scottish Government bodies of sport. In addition, Sportscot and the West Scottish Government Lottery Funds through a range of programmes available to charitable trusts, youth organisations and voluntary sports clubs are covering a wide range of sports and sporting activities. Rob Gibson I thank the minister for his evidence. I would like to focus on kickboxing for a moment. Young Ewan Gleaneski won the under 12 British Championship in the QAN Open last September. When you go to the international level, it takes a lot of expense to support this. I am wondering what Sportscotland is going to do for ensuring that Scottish participants in this worldwide sport can see a lot more Scottish youngsters getting the support that they require. Minister I thank Rob Gibson for the supplementary question. Let me first of all congratulate Mr Gibson's constituent on his achievements. I am always very keen that we do what we can. It is a wide range of sporting opportunities. I did say in my initial answer that much of the funding is channeled through recognised Scottish Government bodies of sport. It is the case at the moment that kickboxing is not an activity that has a recognised governing body. Of course, there is a mechanism for such organisations to become recognised by Sportscotland and details are available on the Sportscotland website. Of course, I did not mention the other range of funding mechanisms that could be used to better support kickboxing. If Mr Gibson wants to contact me further about the specific issue of kickboxing, I would be very happy to get back to him with further details. Thank you, Mr supplementary, from Rhoda Grant. The minister will be aware that Sportscotland put very exacting demands on sports pitches that are designated by them as such. He will be aware that shinty sports clubs are being asked to maintain their pitches at huge expense, almost making them unviable. Will he look at how Sportscotland asks those clubs to maintain their pitches, but will he look at finance for clubs so that they can maintain those pitches and indeed bring shinty out to the wild wider world? I am very much the same as my answer to Mr Gibson. Of course, there are other areas of funding that individual clubs could potentially apply to. I would be very happy to explore the specific point that Rhoda Grant has raised with Sportscotland. I commit to doing that, and I can refer back to Ms Grant with an update. I would observe, though, that it is absolutely right that Sportscotland asks for certain commitments from governing bodies and sports organisations to invest in them, because, after all, it is public funds. I think the points that Ms Grant has well made. I will undertake to look further into them. To ask the Scottish Government what progress is being made with the development of the new Aberdeen women's hospital and cancer care centre? Work on the 120 million new facilities now, the Baird family hospital and the Ancour Centre at the Forrester Hill site in Aberdeen, is progressing well. A governance structure to oversee the project has been established and NHS Grampian has committed resources to support the successful delivery of the project, with key posts now filled or in the process of being filled. Work is in progress to put in place the key advisers needed to support the project. The clinical brief is being developed and is nearly complete. The process is involved with more than 200 staff and public representatives. I thank the cabinet secretary for her answer. The investment in those facilities in the extra £49.1 million this year for NHS Grampian is very welcome. Can I ask the cabinet secretary if NHS Grampian has started on its workforce planning strategy to ensure that, when those new facilities are open, they do so with the right complement of staff? I am certainly pleased that the cabinet secretary has welcomed the additional £49.1 million for NHS Grampian this financial year. In answer to the question on workforce planning, work to develop the clinical brief, the new facility is now nearly in completion. The emerging clinical brief will be discussed at the project board in May. Once the service brief has been agreed in principle, work to undertake the service redesign associated with preparing for those new facilities can begin. That will include the production of comprehensive workforce models to meet the agreed treatment pathways within the revenue budget that is available to NHS Grampian. To ask the Scottish Government what podiatry services are available to older people in Glasgow who cannot afford private treatment. Clinical podiatry services are available free at the point of need to people of all ages who have a clinical or medical need for podiatry care. Those services are provided by highly trained registered professionals in NHS Greater Glasgow and Clyde who assess, diagnose and treat abnormalities and diseases of the foot and lower limb. In 2013, the Scottish Government submitted guidance to health boards advising them that personal foot care is not the responsibility of NHS Scotland. Can the minister advise me why this decision was taken and what should my constituents do to those who cannot afford the free private treatment that has been referred to? Personal care is available without charge for everyone in Scotland aged 65 and over who have been assessed by the local authority as needing it. The legislation includes keeping fingernails and toenails trimmed as one of the personal hygiene aspects of personal care. Family members and or carers can be taught to provide personal foot care as part of the personal care plan or a personal independence payment is designed to assist patients and clients with personal care costs. They can apply for financial assistance and individuals need to go through the DWP or their local council. To ask the Scottish Government how many NHS chief executives were awarded performance-based pay progression of more than 1 per cent based on performance in the years 2014-15. Performance in 2014-15 determines pay for 2015-16 awards have not yet been made since the appraisal process has only just begun. In any case, details of individual pay awards are not held centrally. Given that answer, it could be quite disappointing and alarming that the pay awards for chief executives is not known to the public as to how well chief executives are performing. I also believe that perhaps the front-line staff who are only entitled to a 1 per cent increase would have that right to know. First of all, Scotland is the only part of the United Kingdom where all NHS staff have received 1 per cent increases to cover cost of living rises in 2014-15 and 2015-16. In addition, staff are eligible for progression increases. In the case of chief executives, percentage increases determined by their performance and ranges from 0 to 3 per cent. In comparison, a band 5 nurse could expect progression from just under 3 per cent to over 4 per cent. No member of staff receives progression when they reach the top of their scale. To ask the Scottish Government what discussions it had with NHS Dumfries and Galloway regarding future GP provision. The Scottish Government is committed to developing a national GMS contract in Scotland, which will sustain and support general practice for the future. Scottish Government officials are currently undertaking a series of meetings with all health boards and a large number of local area medical committees involving GPs, conducted jointly with BMA Scotland to learn and collate evidence to inform the future direction. The meeting with Dumfries and Galloway health board took place on Tuesday 3 February. I am grateful to the cabinet secretary for that response, but, as she will be aware, some 20 per cent of Scotland's GP workforce is now over 55 and likely to retire in five to 10 years' time. In my constituency of Dumfries and Galloway and indeed in the health board area, that situation is much worse. On top of that, the official national statistics recently estimated that the lowest population growth for Scotland by 2020 would be 123,000, which would require a further 536 GPs if the 2009 doctor-patient ratio was to be maintained. We have an expanding population requirement for more GPs and an increasing number of GPs likely to retire in the very near future. What is the Scottish Government doing to make sure that we have the estimated between 6 and 900 new GPs by 2020? First, I say to Alex Ferguson that GP numbers have increased by up to 7 per cent. That has seen an increase in GP services of around £70 million under this Government. Alex Ferguson does make an unreasonable point that we need to plan for the future. We are, as I said in my initial answer, in discussions with not just the BMA, the Royal College of GPs and others, to look at the future model of primary care, because it is fair to say that we need to look at the wider primary care team and the role of the GP within that. There is an opportunity, as I am sure that he will be aware, for the first-ever Scottish-only contract, which will begin in 2017, to look at perhaps doing things in a bit of a different way. We are in discussion at the moment. However, meantime, he will be aware that we have made adjustments to the existing contract to reduce bureaucracy and to help GPs to manage the workload more effectively. We are looking to support the recruitment of GPs. We have, of course, the option of salary GPs, where that is a requirement, where there is a difficulty in recruiting to certain areas. Of course, we will be very closely looking at the workforce requirements as we get to the autumn, when we would be looking at GP numbers going forward. There is more work to be done, and I will be the first to acknowledge that. However, I think that we also have to acknowledge the work that has already been carried out, and the number of GPs that have expanded under this Government. 7. Angus MacDonald Thank you, Presiding Officer. In a similar vein to ask the Scottish Government what action it takes to help NHS boards to maintain GP numbers. Under this Government, the number of GPs employed in Scotland has risen by 6.9 per cent to nearly 5,000, the highest of our own record. We have also increased funding by 10 per cent, and there are more GPs per head of population in Scotland than in England. This Government will continue to go on supporting and sustaining Scottish general practice. For example, the recently agreed GP contract aims to give the profession stability over the next three years, reducing bureaucracy and allowing doctors to spend more time with patients. We will continue to work with the RCGP, the BMA and others to find innovative solutions to GP recruitment and retention challenges. The cabinet secretary will be aware of the recent challenges that the Grangements recently amalgamated Kerseybank medical practice, where we have seen an exodus of five GPs in the space of four months. Thankfully, NHS Forth Valley has turned a short-term crisis into an opportunity by taking over the management of the practice this week and creating a new community-based practice. Given that this is a UK-wide problem, not just Forth Valley or Scotland, and that the GP workforce has fundamentally changed over recent years and acknowledging the response to Alex Ferguson's question, what more can the cabinet secretary and the Scottish Government do to address the recruitment problems facing the GP service? First of all, just a little bit more on workforce planning. Although it is the responsibility of NHS boards, support is provided to them in the form of periodic workforce surveys that are conducted by the Scottish Government across general practice. The next one will be undertaken in the autumn of this year, and boards will also conduct their own surveys from time to time. That will give us a clearer, more comprehensive picture of some of the challenges in certain areas, as Angus MacDonald has mentioned, particularly in his own patch. We are continuing to develop a range of initiatives to recruit and support GPs working in general practice, and we recognise that there is more to do to improve the situation. As I said to Alex Ferguson, that is why we are working with the BMA and the profession to achieve that. I am very happy to keep Angus MacDonald and Alex Ferguson updated as to the outcome of those discussions. To the cabinet secretary about the leaf links medical practice in my constituency, where three GPs have left recently and the practice has been unable to recruit any GPs to replace them, 2,000 patients have been told that they must leave that particular practice. Clearly, that is causing great concern in my constituency. I hear what the cabinet secretary is saying about a range of measures, but does she realise the urgency of the situation and has she had any discussions with NHS Lothian about it? I am certainly happy to have a discussion with NHS Lothian and I can certainly get back to Malcolm Chisholm on that. Where there is a difficulty with GP provision, the health board can sometimes assist with that in terms of potentially a salary service or indeed helping the practice to recruit GPs to that practice. There have been some recent changes to pension arrangements, which I think has, unfortunately, in some cases, perhaps speedied up the eerily retirement of some GPs and that is to be regretted. I am certainly happy to speak to NHS Lothian and get back to Malcolm Chisholm with more information. I appreciate, as the cabinet secretary said in her response to Alex Ferguson, that the number of GPs in Scotland has gone up, but in planning for the future, how much weight is being given to the fact that a large number of GPs nowadays both male and female are actually only working part-time in general practice. The net mill hits upon an important point that when you speak to young doctors who are making the decision about which area of medicine to specialise in, many of those young doctors are put off general practice because they do not want to necessarily become involved in the management of a practice with all of the accountancy and staff management that entails. They simply want to operate in general practice. I think that we have to think about that. We have to think about how we can make general practice more flexible. Those are all of the issues that we want to and are discussing with the Royal College, the BMA and others, so that the model of primary care that we can develop going forward, particularly with the opportunity of the new contract for 2017, takes account of all of those issues and makes general practice a more attractive proposition. If we do not do that, young doctors making their choices are not going to come into general practice in the numbers that we need them to. Jenny Marra. Will the cabinet secretary share my concerns about the increasing prevalence of locom GPs who come into a practice and do not know the patient's history, do not know perhaps their family history and the community that can impact their health? Does she share my concerns on the increasing prevalence of locoms and what is she doing to specifically get more salaried GPs so that we do not have to rely on locom GPs? Of course general practice and primary care is in the main still delivered through independent contractors. That has been the model for decades, really, since the national health service was established. However, there has been an increasing number of salaried GPs that have come in to post, particularly to deliver some services, for example in areas of deprivation. I met some excellent salaried GPs in the Westerhales living centre, which is a fantastic centre running a number of services. Salaried GPs have an important role to play, but we have to make sure that we create a mixed model, because it would be very difficult to go from a system that is based around independent contractors to a fully salaried model. That would be very challenging indeed, so I think that a mixed model is the way forward. On the issue of locom GPs, they have been around for a long time because they quite often come in and fill from eternity leave or sick leave and they have a role to play. We absolutely need to make sure whether it is locom GPs or locoms in any other speciality of medicine that, where possible, we ensure that we can recruit to permanent positions and health boards have been trying to do that, but that is not always easy, particularly in some specialities and in some locations. That is why locoms are used, because at the end of the day, what is important is that patients have a service and have someone who is providing that service. If that can only be a locom meantime until recruitment can take place, then that is better than having no service at all. To ask the Scottish Government what initiatives it has to support community-based sporting groups over the coming year. Sportscotney national agency for sport recognises the contribution that community-based clubs make to the development of a world-class system for sport in Scotland. Sportscotney's help for clubs website provides information on funding sources and a wide range of other guidance to support sportsclubs. Colin Beattie The minister may be aware of the Muscleborough Monarchs, a BMX biking group in my constituency. Given the recent resurgence of BMX biking throughout the rest of the UK, but considering that there are only two other clubs in Scotland, can the minister confirm what the Scottish Government will be doing to promote the sport and to help to improve its popularity? Jamie Hepburn Let me thank Mr Beattie for the question at the outset. I am very happy to set out the Government's support for cycling generally. I would point out that Sportscotney invested £1.6 million in the national governing body for cycling from 2013 to 2015, and my support for BMX biking specifically—indeed, I recently visited the Covenal Turians BMX club in my own constituency. I am also very pleased to say that, with support of the Scottish Government Sportscotney and Scottish Cycling, there has been a considerable amount of activity under way to promote cycling BMX biking, in particular through the Lexie 2014 active places fund. We were able to fund a new track at Broadwood stadium in my own area in advance of the 2018 European sports championships. There will be a new BMX track in Glasgow, and a number of community sports hubs now offer BMX as an activity, providing opportunities for riders and raising the profile of sport in local communities. I conclude by wishing a Muscleborough Monarchs well, unless they are in direct competition with the Covenal Turians. Thank you for supplementary from Cameron Buchanan. Thank you very much indeed. Does the Scottish Government consider that participants in sports involving air rifles such as the Tetratholins should not face administrative objectives in training and competing? Of course, the Scottish Government through Sportscotney does support the sport of shooting through Sportscotney, and shooting is a recognised Commonwealth sport in 2013-14. We invested £150,700, which indicates the great support that we place in the sport of shooting. To ask the Scottish Government what additional accident and emergency data it is considering publishing. The Scottish Government statistician started weekly publication of A&E official statistics on 3 March, reporting on the week ending 22 February 2015. Following user consultation of the quarterly A&E publication in the autumn of last year, ISD commenced monthly publication of key A&E statistics in February. ISD is also currently reviewing its publication schedule and timescales with a view to publishing more detailed information about A&E attendances across Scotland following the consultation. The frequency of release has yet to be determined, but a first release will be made late in the summer. That will likely include more about the demographics of people who attend, such as deprivation, gender or ethnicity, the reasons why people may spend more than three hours in departments and more visualisations such as the geographical mapping of A&E attendances. Additionally, ISD is reviewing what information can be published to demonstrate how patients move through unscheduled care services. Just as the Scottish Government has been forced to publish the weekly accident and emergency data, when will the cabinet secretary start to publish the weekly returns from NHS boards on both boarding out and delayed discharges? As I have said in the chamber before, statisticians have been looking at how much information and what information can be put onto the site. We want to make as much information available as possible, and that is why they are working through that at the moment to look at how quickly they can. Of course, it is important that that information is accurate and of good quality. It also takes into account the fact that now delayed discharge is the responsibility of the integrated joint boards that came to life from 1 April onwards, and it is important that any statistical reporting reflects that as well. To ask the Scottish Government what recent discussions it has had with the Scottish Medicine Consortium regarding the licensing of new drugs for the treatment of MS. The Scottish Government has regular discussions with the Scottish Medicines Consortium. Most recently this month, the Scottish Medicines Consortium approved another treatment for MS. As I know that the member is aware from his interest in the issue, the Scottish Medicines Consortium has accepted all treatments for MS where they have received a submission from the pharmaceutical company. For the Scottish Medicines Consortium to continue to be able to accept treatments, they need to continue to receive good quality submissions from the pharmaceutical industry, with a fair offering on price. I thank the cabinet secretary for her answer, and she will be aware that this is MS awareness week. During last year's MS awareness week, I wrote to one of the drug manufacturing companies regarding a drug called Vampira. It is a drug that can make life-changing decisions and mobility for many people with MS. Currently, after much deliberation backwards and forward for the company, I am unaware of a timeline that it has set for submitting the drug. Can the cabinet secretary, or is the cabinet secretary, in a position to provide me with an update on the licence of this particular MS drug? I would also take the opportunity, as George Adam has, to recognise that this is MS awareness week and a good opportunity to highlight the very good work that is going on, not least through the voluntary sector to support people with MS. I certainly welcome the cross-party group's attention to the issue that George Adam raises and the steps that they have taken. The Scottish Government has also raised the issue of non-submission to the Scottish Medicines Consortium, with the pharmaceutical company concerned. I understand that discussions with the SMC are now taking place. However, I would reiterate and encourage the manufacturer to set out a timeline for progressing the submission and to share it with the cross-party group. I am happy to do what I can to support that and to keep George Adam informed. To ask the Scottish Government whether health spending in Scotland has risen less than in England since 2010. The Scottish Government has met its commitment to increase NHS Scotland's resource budget in real terms every year, and that has seen a 5 per cent real terms increase in the five years to 2015-16. We have passed on resource consequentials in full since 2010-11, and in 2015-16 we went further and invested £54 million above consequentials from English health spend. Scotland's front-line health service budget now stands at an all-time record of more than £12 billion a year, and funding is higher per head than in the rest of the UK. In terms of total investment, including capital and non-profit distribution capital investment, the total health investment in Scotland has increased in cash terms by £1.5 billion from 2009-10 to 2015-16. Ian Gray That was a long and convoluted answer to a question to which the honest answer was simply yes. The fact is that, since 2010, health spending in Scotland has increased by 1 per cent in real terms, while in England it has increased by 6 per cent. Can the cabinet secretary explain to us why she has failed to protect the NHS even to the degree that the Tories in England have done so? It is very interesting that Labour says one thing in England, which is to say that the Tories are under funding NHS, and they come here and say how great the Tories are at funding our national health service. The truth of the matter is that this Government has passed on every penny of health resource consequentials and more for 2015-16. The figures that Ian Gray has highlighted from the IFS have not included NPD capital expenditure, and that amounts to around £380 million for 2015-16. Indeed, in looking at 2015-16, health resource spending in Scotland will increase by £409 million, as I said in my earlier answer, taking total health spend to over £12 billion for the first time. That is also clear in this election. It is only the SNP that is putting forward a manifesto commitment to see a real-terms increase in NHS funding, which would be £2 billion for Scotland's NHS by 2020 that has not been matched by the Labour Party in any means whatsoever. In fact, Labour's proposals are to chronically underfund the NHS going forward, something that I think that the voters are seeing through well and truly. To ask the Scottish Government what action it is taking to tackle malnutrition. It is important to note that malnutrition can refer to people who are overnourished, as well as those who are undernourished. The Scottish Government has spent £7.5 million from 2012 to 2015 to encourage healthy eating, especially in our most deprived communities, and we will continue to give the area a high priority. In addition to that, the Scottish Government has invested £300,000 in 2014-15 to enable boards to deliver further improvements in nutritional care. I am hosting a summit on malnutrition on 20 May in Edinburgh, and attendees include medical professionals, Government and NHS officials, the third sector, community groups, academics and representatives from the national nutritional care advisory board and the Food Commission. The summit will look at what causes malnutrition, the impact on the community and what action can be taken to prevent it. There will be specific focus on older people, food access and community health and social care. The minister may be aware of reports from the courier earlier this month on the number of patients being treated for malnutrition in Fife. According to the figures, malnutrition affected some 2,281 patients in 2014, which is an increase on the 2013 figure. It is also a Fife-recorded figure that is significantly higher than Tayside's recorded figure at the neighbouring board. Therefore, what action the Scottish Government is willing to take to address malnutrition specifically in Fife, and if today's issue will guarantee to work with NHS Fife to lower the number of patients who are being treated for malnutrition? I thank Clare Baker for her supplementary question. I do not know if she has been in contact with NHS Fife directly on this, but the reason the figure is so high in Fife is that they have used a more diverse ICD 10 code list than other health boards and have included multiple admissions of patients with malnutrition. I am sure that NHS Fife will be engaging with the health summit, and I am more than willing to engage with NHS Fife directly on the subject. To ask the Scottish Government how many cases have been reported to ministers of private and confidential information held on patients being lost left in public places or breached. In August 2014, the Scottish Government introduced a new approach to categorising incidents, and it has started to record figures and details on significant information security incidents. One incident has been reported since the new approach was introduced. It is, of course, totally unacceptable that private and confidential information held on patients is not 100 per cent secure, and we have seen a number of data breaches over the years. What action has been taken to put the situation right? With the NHS increasingly moving towards electronic records and information sharing, what provisions are being put in place to safeguard patients' confidential data? As Nanette Milne said herself, it is not unacceptable when breaches occur. Thankfully, they have always been fairly minor in nature, although I can understand the worry that that still generates. It is important to make the distinction between those minor incidents where there is no serious concern for the patients involved and those major incidents of which I said that there was one. In terms of the work going forward, there is a lot of work under way to make sure that the opportunity is minimised for any loss of data, whether that is through paper data or electronic data. That involves processes and procedures and training. I can certainly write to Nanette Milne to update or certainly on the electronic side of matters as we move more towards having a more paperless system. To ask the Scottish Government how many general practices have been unable to recruit one or more partners for more than six months? Numbers of vacancies for GP poster are not held centrally as this is a matter for individual GP contractors as employers. As part of a move towards better quality, more regular and more consistent information, preparations to conduct a workforce survey later this year are under way, aiming to obtain robust and accurate information on the numbers, gender, age profile, working patterns, contractual status and workload of GPs and other staff working within GP practices in Scotland. I would encourage all practices in Scotland to assist us in ensuring that this information is as robust as possible by taking part in the survey. In addition, we are also seeking to profile the GP workforce in terms of how it is placed to deliver high-quality services for Scotland's people in future, whether in hours or out of hours. I thank the cabinet secretary for her response, but given the closure of practices to new patients and the growing number of practices that are already having difficulty in recruiting and retaking GPs and now also with the BMA survey showing that many GPs are intending to retire as many as one in five are considering emigrating, how is the Government planning to recruit between 563 and 915 additional GPs by 2022? As I said earlier in my earlier answers about the subject, we have seen an increase in the number of GPs, we have seen an increase in the investment over recent years as well, but there is more to be done. There is a current issue of GPs perhaps retiring earlier than they would have due to some changes around the pension contributions, but we absolutely have to look at the model of primary care going forward to make sure that it is not just about GPs themselves, but it is about the wider primary care team. It is about the issues of flexibility that I responded to in the answer to in the net mill. It is about how we make general practice more attractive, because at the moment we have GP training posts that we are not able to fill because we are not getting the interest from doctors wanting to go into general practice in the way that we need. So yes, we could expand GP training numbers, but if we have difficulty filling the ones that we have at the moment, then there is a wider issue going on about how attractive general practice is. We have to address that, we have to make it a more flexible profession to enter into, and that would be partly through not just the independent contractor-based practices, but also the use of salaried GPs where appropriate. I am happy to keep Anne McTarger up-to-date on some of those discussions as we take them forward. To ask the Scottish Government whether it will review a place-to-be smoke-free campaign. A place-to-be smoke-free campaign is an NHS-5 campaign to support the implementation of its smoke-free grounds policy. That has been accompanied by new smoke-free signage across the NHS-5E state. NHS-5 is monitoring compliance with its smoke-free policy on an on-going basis. Initial observations are that there has been a reduction in smoking and in tobacco-related litter across NHS-5 grounds. Tobacco is the biggest cause of preventable ill health and early death in Scotland. This Government is committed to tackling that, and I welcome the efforts of all NHS boards, including NHS-5 and NHS Scotland, in implementing and supporting smoke-free policies. That might be difficult for some smokers, but this is a positive response to complaints about smoking on NHS grounds from staff, patients and visitors. I also thank all those patients, visitors and staff for their efforts to respect those. I thank the minister for that answer, but she may be aware of a number of reports circulating in the press, including the courier, on 20 April, suggesting that substantial numbers of people are flaunting the ban. Can the minister advise whether the Scottish Government is considering introducing a ban in the public health bill? I thank Roger Campbell for his supplementary question. I still think that it is early days in the new policy of smoke-free NHS grounds, and this approach is not about enforcement but about raising awareness and changing culture. However, I recognise that chief executives are concerned about compliance, and we recently consulted on a range of legislative proposals relating to tobacco and Ease of the Rits, including what action, if any, the Scottish Government should take to support NHS smoke-free grounds. I will announce our response to that consultation shortly. If the question and answer is very brief, I call question 16, Richard Lyle. Thank you, Presiding Officer. To ask the Scottish Government when it will ask to discuss football club funding with Peace, IB, ITV and BBC. The First Minister sent a letter to Tony Hall, director general of the BBC on 2 April 2015, asking about the disparity between the BBC's investment in English and Scottish football. We have not raised the issue with any other broadcasters yet, but intend to do so. Richard Lyle reports that many individual football clubs in England will receive an average of yearly payment of more than 100 million or more in regard to football funding from television companies. Would the minister agree with me that UK sports channels should look to improve their payment allocation made to SFA and Scottish football clubs in general? Yes, indeed. The First Minister received a response from Tony Hall stating that the BBC does not control the sports rights market and that they have to consider a value for money for the licence fee pair, whilst I accept the need for them to consider a value for money. I also hope that they can understand the concern that exists about the disparity in their investment in English football as opposed to Scottish football or that they do not want to exaggerate the extent that the Scottish Government can influence those matters. We stand ready to assist the SFA in the SFA film this matter, if we can. Many thanks, minister. That concludes portfolio questions, and we now turn to the next item of business. I will allow a few moments for members to change positions.